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Examination of electron transport chain function in muscle and fibroblast culture, histological and electron microscopy examination of muscle and other biomarkers of mitochondrial metabolism revealed a pattern consistent with the notion that PPA could be interfering with mitochondrial metabolism at the level of the tricarboxylic-acid cycle (TCAC)

Your patient's self-directed use of pantethine and L-carnitine reflects a reasonable hypothesis about mitochondrial dysfunction in ME/CFS, but requires struc...