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Euglycemic DKA (ketoacidosis without markedly elevated blood glucose) can occur and requires immediate medical attention

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Hours after the initial trigger, mast cells produce and secrete certain chemokines (TNF, CCL2, CCL8) and renin.[ref] The different mediators released can lead to different symptoms of mast cell activation syndrome: Histamine leads to headaches, migraines, low blood pressure, itching, stomach acid release (and much more) Tryptase causes inflammation and fibrinogen lysis

Some symptoms are expected during adaptation

Although lecithin, creatinine and betaine are technically precursors to TMA, pilot studies have shown no significant effect on the production of excess TMA/TMAO in urinary analysis at normal dietary levels of consumption