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But if enzymatic function is impaired, nutrient cofactors are deficient, or toxins/ microbial byproducts inhibit pathways, these can become blocked, causing abnormal organic acid buildup in urine
Episodes often occur in the early morning hours or upon awakening in the morning
doi: 10.1016/S0162-0134(02)00511-1 600 MladnkaPMackovKFilipskTZatloukalovLJahodLBovicelliPet al
It is comprised of five amino acids and is classified as a secretagogue
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