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When it occurs, it may indicate: Tissue invasion Inflammation Nerve involvement Tender lesions warrant examination, especially if appearance changes accompany discomfort

Beyond direct astrocytic toxicity, ammonia interacts with systemic inflammation to promote microglial activation and subsequent neuroinflammation [31]

Most of the studies evaluated the cardiovascular outcomes using a composite outcome of major adverse cardiac events (MACE) or one of its components, cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke

Other side effects can include dizziness, mild tachycardia (increased heart rate), infections, headaches and indigestion