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This alteration is accompanied by a metabolic change from glycolysis to a more oxidative form given by a decrease in phosphoglycerate mutase 1 (PGAM1), ALDOA, LDHA/B, and an increase in succinate dehydrogenase (SDH) A/B/C/D from the ADP-forming beta subunit of succinate-CoA ligase (SUCLA2), aconitase 2 (ACO2), PDK, and pyruvate dehydrogenase phosphatase (PDP), among others

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Reputable providers, including Eden, should document baseline metabolic labs, cardiovascular history, thyroid cancer risk assessment, contraindication review, and structured follow-up protocols