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Many patients find shakes easier to tolerate 3-7 days after their weekly injection when nausea subsides, and spreading protein intake across multiple small servings throughout the day optimizes tolerance and muscle protein synthesis

Glutathione synthetase deficiency has been incriminated as the cause of chronic hemolytic anemia alone (due to isolated RBC enzyme deficiency) and as the cause of a generalized syndrome (due to enzyme deficiency in many tissues) characterized by mild hemolytic disease, severe metabolic acidosis, and mental deterioration

GSH is a major bioprotectant substance in cells