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This is because doses above 40 mg may cause a depletion in copper levels

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Nature 2023;619:37177

In aged tendons, tenocyte activity is impaired, and functionally compromised pro-inflammatory tenocytes accumulate ( 9 Conclusion Tendon injury is a major musculoskeletal disorder that causes pain, limited activity, significant disability, and lost productivity

Perhaps the most promising to date, however, is ALDA-1, which was originally developed as a small molecule activator of ALDH2, but more recently has been shown to also activate ALDH1a1 with similar potency (239, 240)

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