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For those with anemia or known deficiencies, B12 injections can be particularly effective in restoring balance

When acute illness occurs in PA, propionic acid accumulates leading to biochemical features including profound metabolic acidosis (due to ketone body production and organic acid accumulation), hypoglycemia, and hyperammonemia (see figure below)

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Indika N-LR, Frye RE, Rossignol DA, Owens SC, Senarathne UD, Grabrucker AM, Perera R, Engelen MP, Deutz NEP (2023) The rationale for vitamin, mineral, and cofactor treatment in the precision medical care of autism spectrum disorder