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Storage considerations with multiple draws Drawing from the same vial multiple times per week accelerates degradation and increases contamination risk

Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E

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Pathways involving glutamate, aspartate and lipids (phosphatidylcholines (PC)

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The resulting catastrophic energy deficit is a primary physiological driver of post-exertional malaise (PEM) or 'crashes,' where even minor, everyday activities trigger a disproportionate and prolonged exacerbation of profound fatigue, muscle weakness, and cognitive impairment