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This is one of the more puzzling effects some people report

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Severe hepatic impairment may influence the suitability of this medication for certain patients

Severe symptoms interfering with work, social activities, or sleep warrant medical discussion even if no underlying pathology is identified

While these findings are highly promising, the substantial heterogeneity ( I 2 = 49%) reflect more recent trial outcomes which have not shown statistically significant N-acetylcysteine and placebo differences

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