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Gradually increasing fiber intake while maintaining adequate hydration helps prevent gastrointestinal discomfort during the transition

Beyond gastrointestinal effects, clinicians should monitor for several less common but clinically significant adverse events

PMID: 28274611 13 Hypocarnitinemia Observed in an Infant Treated with Short-Term Administration of Antibiotic Containing Pivalic Acid

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First is indirectly by virtue of the fact that someone is losing a lot of excess weight and, or the persons diabetes is coming under better control

Always follow medical advice on dosing, which may vary based on individual health needs