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Because there is not enough high-quality human evidence to support routine clinical use and they are not currently approved for use in Humans by Health Canada or the FDA

Drug Interactions and Hormonal Effects There are no well-established drug interaction profiles for Epitalon

a recent safety analysis found no anaphylaxis in hundreds of patients receiving high-dose IV thiamine, suggesting the risk is very low in practice

HPLC checks have all come back clean

Subcutaneous injection bypasses first-pass hepatic metabolism and delivers near 100% bioavailability, which is why all published rodent studies use injection rather than oral dosing