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The highest rates are observed among patients with prosthetic valves, intracardiac devices, unrepaired cyanotic congenital heart diseases, or a history of infective endocarditis

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Splitting ALA into smaller doses may help reduce gastrointestinal side effects, especially at higher intakes.43 Taking ALA with food can also improve tolerability though some studies suggest it may slightly reduce absorption.13 44 That tradeoff may be worth it for users sensitive to GI effects, particularly when taking ALA long-term