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NAC is likely safe for adults when provided as a prescription medication

While these options can be beneficial, B12 Injections remain the fastest and most reliable method of absorption, particularly for individuals with deficiencies or greater nutritional needs

201 A meta-analysis that reported findings from 23 randomized controlled trials involving 842 participants with stage 35 CKD indicated that probiotic, prebiotic, and synbiotic supplements improved creatinine and BUN levels, heightened markers of oxidative stress, reduced some markers of inflammation, and decreased uremic toxin levels

1987 Apr;48(4):1252-7

They are regulated by the Controlled Substances Act set up by the DEA

Lastly, it is well known that prolonged cholestasis can induce cirrhosis and consequent disruption of gut barrier function and integrity [207]