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Long-term DSIP safety has not been established through clinical trials

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Importantly, some of the same metabolic pathways that provide substrate for epigenetic chemical modifications are also sensitive to energy balance and fasting, including methionine metabolism and the supply of DNA methyl donors, catabolic production of acetyl-CoA from glucose and lipids to supply substrate for histone acetylation, and ketogenesis with ketones such as β-hydroxybutyrate exhibiting direct inhibitory properties on the action of histone deacetylases, while also providing substrate for β-hydroxybutyrylation of histone lysines (159, 160)