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Increased oxidant production can promote depletion of nitric oxide by many mechanisms, including the direct reaction of nitric oxide with superoxide to produce peroxynitrite

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DSIP should be approached with particular caution by individuals with severe psychiatric conditions, untreated sleep disorders like severe sleep apnea, or those taking medications affecting the central nervous system

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Over time, this deficiency can lead to nervous system problems, fatigue, anemia, and mood changes