The liver processes the E/P Protocol medication but it does not adversely elevate liver enzymes. We'd like to point out that oral anabolic steroids are liver-toxic. We do not use these. While all medications have a possibility of side effects, different classes such as the Selective Estrogen Receptor Modulators (SERMs), such as Enclomiphene, are much safer. The SERM most commonly used in the Maximus Testosterone Protocol has not shown to have adverse events in clinical trials, side effects are rare (~1-3%), very mild (e.g. headache, nausea), and actually no different than what a person experiences taking placebo pills, so are likely not due to the medication itself. For more info: https://www.maximustribe.com/science