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The ROS generated by haemichromes on the erythroblasts membrane poses a challenge to removal by the cytoplasmic antioxidant system, and readily oxidizes lipid and protein constituents of the cell membrane, leading to severe oxidative damage

Interestingly, treatment withdrawal did not completely restore the mRNA transcripts, and a similar effect was observed for vitamin D metabolism genes and genes associated with NAFLD which was persistently higher, suggesting the epigenetic association between GSH deficiency and vitamin D metabolism genes

However, oral supplementation is not without disadvantages, including absorption challenges in the gastrointestinal system

When treatment is discontinued, appetite returns, metabolic rate adjustments reverse, and weight regain begins