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Extreme restriction is unnecessary and often counterproductive, causing metabolic slowdown that persists beyond the protocol

doi: 10.3390/nu15132823 17 HellmannHMooneyS

Although guidelines suggest cautious use in compensated cirrhosis and avoidance in decompensated liver disease, a large retrospective cohort study found no significant drug-induced liver injury from naltrexone and no attributed decompensations, supporting its use in both compensated and decompensated cirrhosis with close monitoring [120,121]