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It causes oxidative damage to the cells lining blood vessels (endothelial cells), which promotes a hypercoagulable state

Be aware that to improve taste, some formulations other than pills include sugar substitutes (such as mannitol, sorbitol, and/or sucralose) and, in some people, these can cause gas, bloating, and diarrhea (Grembecka, Eur Food Res Technol 2015)