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Wilson M, Andronesi O, Barker PB, Bartha R, Bizzi A, Bolan PJ, et al

Low endurance despite adequate nutrition and sleep Need to rest during normal daily activities Symptoms worsening after physical or mental exertion Brain fog after concentration or problem-solving Unrefreshing sleep Inconsistent energy or afternoon fatigue Heat intolerance or impaired temperature regulation Frequent infection or slow recovery Rapid fatigue during high-intensity activity Poor exercise recovery and prolonged soreness Low SAM despite adequate methionine Patterns suggesting impaired ATP-dependent methylation 8-OHdG and lipid peroxides Organic-acid and mitochondrial pathway markers Hair mineral analysis, including manganese Copper, ceruloplasmin and plasma zinc Evidence that other energy-dependent pathways are also impaired Why this pattern is broader than magnesium deficiency Conversion of methionine into SAM requires ATP

Dev Neuropsychol 27(3):311336

Studies have reported a higher mutational burden in blood and possibly other tissues of PLWH compared with age-matched controls

Chaurasia, S