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In naturally aged mice, FOXO4-DRI improved the testicular microenvironment and alleviated age-related testosterone secretion insufficiency with decreased p53, p21, and p16 protein levels in treated testes compared to aged controls

Most of these side effects resolve on their own

Others may introduce additional degradation pathways

Key risk factors include: Pernicious anemia Gastrointestinal or autoimmune disorders Alcoholism Those who have undergone bariatric surgery, adhere to strict vegetarian diets, or have long-term use of antacids or proton pump inhibitors are also susceptible