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Pregnancy, breastfeeding, and certain pancreatic conditions also rule it out

These stable adducts can continuously disrupt the replication and transcription process of mtDNA and damage the structural integrity of mitochondria, thereby leading to mitochondrial respiratory chain dysfunction: obstruction of the electron transport chain leads to increased electron leakage, and free electrons combine with oxygen molecules to generate superoxide anions (O 2 ), which further induce the production of a large amount of Reactive Oxygen Species (ROS) and trigger a strong oxidative stress response

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The non-accidental ingestion of a very high dose of lipoic acid led to multi-organ failure and subsequent death of an adolescent girl (117)