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Because it doesnt contain deoxycholic acid or another recognised medicinal ingredient, its treated as a cosmetic product under general product safety law rather than as a medicine

Tyramine is broken down not by diamine oxidase (DAO) but by a different enzyme called "monoamine oxidase" (MAO)

In another paclitaxel-induced peripheral neuropathy (PIPN), 4-PSQ was observed to decrease paclitaxel-induced mechanical and thermal hypersensitivity, possibly related to modulation of oxidative stress in the spinal cord, hippocampus, and cerebral cortex of PIPN mice [163]

The first step is to run a blood test that measures the level of the thyroid hormone called thyroxine (TT4)