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Meanwhile, long-term use also disrupts intestinal microbiota (bacteria and fungi), risks multidrug-resistant fungi, and carries hepatotoxic or even fatal side effects 169,170

It inhibits tyrosinase, a key enzyme involved in melanin production, and it also shifts melanin synthesis towards lighter pheomelanin rather than darker eumelanin, contributing to brighter-looking skin. Mechanism of action on pigmentation Melanin is the pigment responsible for skin colour, and its overproduction contributes to tanning, dark spots, and uneven tone

The subsequent NO deficiency impairs flow-mediated dilation and promotes vasoconstriction, increasing vascular tone and contributing to hypertension

A deficiency of tryptophan is known as Pellagra which causes a deficiency of niacin