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Contemporary practice increasingly favors individualized risk stratification, multidisciplinary communication, and shared decision-making to balance aspiration prevention with the metabolic benefits of continued therapy

However, in the case of high amounts of NAPQI, which is a strong electrophile and can react with different nucleophiles, glutathione (GSH) plays a crucial role in neutralizing it

Preliminary studies suggest neuroprotective, immunoregulatory, and vision-preserving effects Khavinson et al., Neuroendocrinol Lett , 2003

10.1016/S0749-3797(03)00113-2

Trial participants on the highest dose lost roughly 15% of body weight over 68 weeks, a number so far above what any prior pharmacotherapy had achieved that endocrinologists who had spent careers managing modest expectations had to recalibrate the conversation in real time