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Clinical trials are needed to identify biomarkers that predict response to metabolic interventions and to determine the optimal combination therapies that can overcome resistance mechanisms

Trimetazidine significantly downregulated carbohydrates, such as glucose, fructose, galactose, and mannose, indicating that the administration of trimetazidine strengthened the metabolism of carbohydrates in the myocardium and enhanced the glycolysis process

They may worsen panic, insomnia, irritability or palpitations when copper overload or overmethylation already produces excessive catecholamine activity