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Signs of ALA toxicosis can occur 30 minutes to several hours postingestion and include vomiting, ataxia, hypersalivation, tremors, and hypoglycemia

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Komatsu M, et al

Yendamuri S, Komaki RR, Correa AM, Allen P, Wynn B, Blackmon S, Hofstetter WL, Rice DC , Roth JA, Swisher SG, Vaporciyan AA, Walsh GL, Mehran RJ

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Hereditary glutathione reductase deficiency generally impairs cellular energy balance and increases the level of oxidative stress in red blood cells and has been related to hereditary hemolytic anemia 9,10