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Very rarely, pancreatitis, kidney dysfunction, or medullary thyroid cancer (animal studies only) may occur

Not just drugs, even gambling may be affected

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Common contributors may include: oxidative stress smoking or alcohol excess obesity and metabolic dysfunction heat exposure varicocele genital tract inflammation or infection poor sleep and chronic stress nutritional gaps idiopathic male infertility, where no single obvious cause is found Among these, oxidative stress is one of the most discussed mechanisms

Furthermore, in a human study, rikkunshito treatment notably increased ghrelin and the ghrelin/desacyl-ghrelin ratio, whereas the levels of desacyl-ghrelin exhibited a declining pattern (133)