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The second major phase involves the conversion of GDP-D-mannose formed previously into GDP-L-galactose during three reactions catalyzed successively by GDP-D-mannose 3,5-epimerase, GDP-L-galactose phosphorylase and L-galactose 1-P phosphatase

After loading, transition to maintenance dosing of 1000 mcg every 1 to 4 weeks depending on response and follow-up testing

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So uric acid is a huge player in terms of our immune system physiology and in terms of our path of physiology across a wide spectrum of chronic degenerative conditions, well beyond gout, including cognitive decline, cardiovascular disease, diabetes, dysregulation of insulin and elevation of blood glucose, inflammation, as I mentioned, and even more interesting from my perspective based upon where my work is going these days: elevation of uric acid is damaging to the function of our cells energy providers called the mitochondria, meaning that when uric acid level is elevated, its messing up the way our cells can use fuel for energy