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immediate labs if new medications are added or symptoms develop If ALT/AST rise above 2x upper limit of normal: Hold both agents, investigate, and reintroduce one at a time after normalization This schedule is conservative

Adv Healthc Mater 11(20):e2201140

10.1002/jor.20096 69 KrivicA.MajerovicM.JelicI.SeiwerthS.SikiricP

S., Wan, T

This theory also proposes that malfunction of an as yet undiscovered lactate shuttle within the NMJ may be a pathological feature of ALS, suggesting that supporting mitochondrial function may optimize lactate metabolism and combat the toxicity caused by accumulation of excess lactate

Oxidative stress levels are raised in chronic fatigue syndrome and are associated with clinical symptoms