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Stevenson DA, Anaya TM, Clayton-Smith J et al : Unexpected death and critical illness in Prader-Willi syndrome: report of ten individuals

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Oxidative gene reprogramming ERRs activate hundreds of target genes: mitochondrial biogenesis (NRF1, TFAM), oxidative phosphorylation (complex I, II, III, IV, V subunits), fatty acid beta-oxidation (CPT1B, MCAD, LCAD), Krebs cycle (IDH3, SDHA), type I fiber specification (myoglobin, Myh7, slow troponins), angiogenesis (VEGF-A)

Some higher-dose trials reported weight loss averages up to 20%

Important safety considerations: Avoid unregulated sources, including medications purchased from non-UK websites or social media sellers