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While this is generally only a concern at extremely high doses, patients with unmanaged hypothyroidism should monitor their thyroid function when beginning supplementation

On the other hand, 3-hydroxybutyric acid, together with nicotinic acid, has shown to confer anti-inflammatory effects in TNF- by decreasing the level of pro-inflammatory proteins (iNOS, COX-2) or secreted cytokines (IL-6 and IL-1) 24 , which might explain the continuously increased levels of 3-hydroxybutyric acid observed in the different COVID-19 positive groups

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These results further confirmed a defective cell adhesion phenotype in cells with reduced Pttg2 levels

10.1002/jcb.23333 J