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If upregulation of citrate synthase occurred due to excess PPA in vivo and then PPA was removed in vitro , the high activity of citrate synthase in vitro would overproduce citrate and enhance the proximal portion of the TCAC, which preferentially produces NADH, the electron carrier metabolized by complex I

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Despite appearance of some adverse effects including dizziness, headache and nausea, these events are generally mild and well tolerated

Rapid Commun Mass Spectrom, 23(35)

Hydrogen sulfide, a molecule needed by the body in just the right amount, at low levels, acts as a mitochondrial electron donor, but at high levels, it is poisonous to the mitochondria