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J Infect 35(2):143147 Walmsley SL, Khorasheh S, Singer J, Djurdjev O (1998) A randomized trial of N-acetylcysteine for prevention of trimethoprim-sulfamethoxazole hypersensitivity reactions in Pneumocystis carinii pneumonia prophylaxis (CTN 057)

For example, alpha lipoic acid is known for its antioxidant role in cellular energy metabolism, green tea polyphenols are studied for protection against oxidative damage, grape seed and pine bark extracts are associated with microcirculation and collagen support, while biotin, zinc, and vitamins A, C, and E contribute to normal skin maintenance

However, some formulations contain additional ingredients that may be comedogenic for sensitive individuals

Importantly, folic acid should not be given alone before B12 deficiency is excluded or treated, as this can mask anaemia while allowing neurological damage to progress

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