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ROS might act as a signaling molecule and activate the antioxidant proteins by interacting with signaling partners such as respiratory burst oxidase homolog (RBOH), G-proteins, Ca 2+ , mitogen activated protein kinases (MAPKs), and various transcription factors (TFs)

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Notably, TTM is considered highly unstable under conventional use and is ineffective when used as a single agent

Biochemical tests for MMA may show elevated levels of blood propionylcarnitine and/or elevated propionylcarnitine to acetylcarnitine ratio, and markedly elevated urinary methylmalonic acid and methyl citrate [11]