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[7] Blood glucose should be monitored, and medication doses may require adjustment Skin reactions : Rash or itching has been reported in some individuals Thiamine deficiency : Chronic high-dose ALA may theoretically interfere with thiamine (vitamin B1) metabolism, particularly in individuals with alcohol use disorder [20] [21] Insulin autoimmune syndrome : Rarely, ALA has been associated with this condition causing unexpected hypoglycaemia

That lack of energy is known as fatigue, and dealing with it all the time can affect your ability to feel motivated about doing anything, even getting out of bed

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