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It is vital to pay attention to the onset of these symptoms if they: Persist for a long period Gradually intensify Are not associated with apparent stressors Worsen independently of external factors If a combination of symptoms appears, it is recommended to conduct a thorough testing to identify possible deficiencies and start treating nutrient deficiencies in time

Koeller DM et al (2002) Biochemical, pathologic and behavioral analysis of a mouse model of glutaric acidemia type I

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Funding This research was funded by the National Natural Science Funds of China (grant numbers 82074234 and 82071756), Shanghai Chinese Medicine Development Office, National Administration of Traditional Chinese Medicine, Regional Chinese Medicine (Specialist) Diagnosis and Treatment Center Construction Project-Rheumatology, State Administration of Traditional Chinese Medicine, National TCM Evidence-Based Medicine Research and Construction Project, Basic TCM Evidence-Based Capacity Development Program, Shanghai Municipal Health Commission, and East China Region based Chinese and Western Medicine Joint Disease Specialist Alliance

In skeletal muscle of UBE3B KO mice, there is an accumulation of BDK that leads to a decrease in BCKDH complex activity, but this does not correlate with changes in BCAA levels, indicating that BCKAs could be driven to other pathways (Ziegler et al., 2017), therefore BDK accumulation may disrupt the regulation of lipogenesis in developing neurons

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