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A 2019 safety review examined 87 human studies on natural astaxanthin including 35 using doses of 12mg per day or higher and found no significant safety concerns or consistent adverse effects.11 Across those trials, approved or studied doses commonly ranged between 2mg and 24mg per day, and higher short-term doses (up to 40mg per day for several weeks) have also shown good tolerability in adults, with no serious events reported

Different from PCD, secondary carnitine deficiency (SCD) is mostly caused by drugs (such as valproic acid, anticancer drugs, omeprazole, amphoteric drugs, etc.) or diseases (such as fatty acid oxidation disorder, organic acidemia, etc.) (73, 74)

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doi: 10.3389/fcdhc.2025.1718498 7 WangJPiHSunQ

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