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Degradation of BH4 by oxidative stress: During periods of high oxidative stress, BH4 is oxidized to BH2 at a higher rate.[ref] Research shows that H2O2 (peroxide), interferon-gamma (IFN), tumor necrosis factor alpha (TNF), and lipopolysaccharide (LPS, from bacteria) all increase the need for BH4.[ref] What causes oxidative stress

Increased heart rate: Some patients may experience a higher resting heart rate

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For those patients, the spray works well

It hurts liver cells and considerably lowers glutathione levels

Back then, people were still trying to figure out how to pronounce it