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Deficiency can show up as fatigue, weakness, numbness/tingling, balance problems, memory issues, and megaloblastic anemia

While 33% of patients showed a grade 3 acute toxicity (including 2 diarrhea, 1 rash), no grade 4 or 5 toxicities were observed during 10 months follow-up

Do not begin, stop, or change a prescription medication or supplement solely because of a laboratory result

This suggests that chronic disruption of the TCA cycle, as opposed to acute inhibition, may be an adaptive response to metabolic changes

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7 , e0219 (2023)