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When long-chain fatty acids cannot enter the mitochondria due to a broken carnitine shuttle, they accumulate in the cellular cytoplasm

All these findings also suggest that ferroptosis is associated with kidney stones, as both lipid peroxidation and reduced antioxidant enzyme activity are biochemical features of ferroptosis

This is the core reason oral capsules and sublingual drops consistently underperform in clinical studies compared to parenteral routes

Also, bile acids metabolism has been described as involved in atherosclerosis development: it is probably related to bacterial bile salt hydrolyzation, which can stimulate enlargement of atherosclerotic plaque through cholesterol accumulation and foam cell formation [68]

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