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The combination of hyperpigmentation, macrocytic hyperchromic anemia, pancytopenia, and low Vitamin B12 levels was indicative of megaloblastic anemia secondary to Vitamin B12 deficiency

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However, in October 2025, a trial participant experienced a severe adverse event, with highly elevated liver enzymes and bilirubin

This suggests that a resistance exercise-related mechanism of inducing plasma NO, perhaps due to increased shear stress that triggered an up-regulation in NO-cGMP signaling along with a slow, sustained release of NO from GSH + CIT, may be a conceivable candidate for this response