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Rare: flushing, nausea

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Always review medication lists carefully especially when starting dialysis

Taking extra medication only increases the concentration of the drug to toxic levels, which will likely make you too ill to maintain the healthy eating and exercise habits necessary for long-term success

Alternatives include specialist dietetic support tailored to inflammatory bowel disease, structured lifestyle interventions through NHS tiered weight management services, cautious use of alternative medications such as orlistat (with gastroenterology input), and bariatric surgery for suitable candidates with well-controlled disease following multidisciplinary assessment

However, the BHMT reaction is limited to the human liver and kidney since BHMT is expressed primarily in the hepatocytes and kidney cortex (Sunden et al., 1997)