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Reported or theoretical concerns may include: Injection-site reactions Transient headache Nausea or mild gastrointestinal discomfort Fatigue or energy fluctuations Unknown long-term effects Potential immune reactions or quality concerns with non-regulated products Theoretical concerns include potential over-suppression of inflammatory responses at high concentrations, so monitoring markers such as CRP and IL-6 during extended use may be recommended by a qualified clinician

doi: 10.1590/S1677-5538.IBJU.2015.01.15 51 De SouzaMRDe SouzaMFDe NbregaMCilioHLDos ReisMBFugantiPEet al