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According to the National Academies of Sciences, Engineering, and Medicine (NAP), a safe highest level is called the tolerable upper intake level. Assessment of what amount is too much is based on animal and human studies, published evidence of adverse events, and professional agreement based on a committee of experts

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Methotrexate requires regular blood work (CBC, liver function tests, kidney function) to monitor for bone marrow suppression and hepatic or renal toxicity