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Although the efficacy and safety of such products is still a matter of debate

Darkness on the neck is often caused by a condition called Acanthosis Nigricans, which is commonly associated with insulin resistance, obesity, hormonal imbalances (like PCOS or thyroid disorders), or side effects from certain medications

Liver injury is also developed following MTX administration characterized by elevated liver function biomarkers (Bannwarth et al

Clinical presentation may range from asymptomatic to symptoms of acute liver failure Liver failure Severe inability of the liver to perform its normal metabolic functions, as evidenced by severe jaundice and abnormal serum levels of ammonia