ALCAR is naturally found in the blood and tissues of horses
A COA that only reports purity without confirming molecular weight (approximately 4963 Da for full-sequence TB-500) cannot distinguish between these
Clinical Trials Meta-analyses The first independent appraisal of antioxidant therapy for pain control in patients with chronic pancreatitis covered reports on randomized controlled trials (RCT) up to 2009, and concluded that the identified micronutrient combination ( Section 3) improved outcome in each of three placebo-controlled studies (159, 80, 10), but that meta-analysis was impossible because different instruments were used to measure pain (104)
Headache Mild stomach upset Flatulence Nausea and vomiting Patients with bipolar disorder may develop mania Patient Warnings: Patients taking selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, or other drugs that affect serotonin levels should avoid taking SAM-e without the supervision of a physician due to case reports of mania and serotonin syndrome, a serious condition, or other side effects
References Carson SA, Kallen AN
This is probably the question researchers ask most frequently