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Beyond 28 days, degradation accelerates, particularly if the vial has been accessed multiple times (each puncture introduces trace contaminants and air)

Although originally formulated for hepatic pathology, the similar metabolic principles apply to the central nervous system: increased systemic and brain-local acetaldehyde formation, CYP2E1 induction, and mitochondrial oxidative stress provide a biochemical substrate for neuronal and glial injury, thereby linking drinking patterns and individual susceptibility to region-specific neurodegeneration

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Trials that showed benefits used dosages between 1200 and 2700 mg per day for 1224 weeks

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