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Costin, 1988

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There is an herbal option

Two-day cardiopulmonary exercise testing in females with a severe grade of myalgic encephalomyelitis/chronic fatigue syndrome: comparison with patients with mild and moderate disease

A case report found that taking very high doses of over 5 grams of extended-release niacin can lead to metabolic acidosis, a buildup of acid in body fluids, as well as acute liver failure both of which can be fatal ( Keep in mind that these potentially deadly side effects are associated with taking exceptionally high doses of vitamins