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It's very, very strict. When it comes to compounded medications, the regulation can vary

[27] However, 3% to 6% of people given intravenous acetylcysteine show a severe, anaphylaxis-like allergic reaction, which may include extreme breathing difficulty (due to bronchospasm), a decrease in blood pressure, rash, angioedema, and sometimes also nausea and vomiting

If you catch Hashimotos in stage 1, you may be able to get by just going gluten-free or dairy-free