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These emerging risks add to concerns already listed on the warning labels: gallbladder disease, kidney injury, and a possible (though unproven) risk of thyroid tumors

Topiramate may cause metabolic acidosis which can cause kidney stones, weak bones, harm to an unborn baby, and growth problems in children

[1] The mechanism likely involves the extract traveling down the gastrointestinal tract as a high-concentration bolus, triggering hormones along the way