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Other chronic effects include vitamin D deficiency, osteomalacia, carbohydrate intolerance, immunologic disturbances, hypothyroidism, and peripheral neuropathy

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Metabolism of the seven-carbon fatty acids in triheptanoin also results in increased production of ketones (-ketopentanoate and -hydroxypentanoate) which easily cross the blood-brain barrier (BBB) and are utilized by neural tissues.

Remember how we discussed there were two ways normal valproic acid metabolism could ultimately interfere with the urea cycle