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VPA causes over-regulation of the cluster of differentiation 36 (CD36), an essential fatty acid transporter, and diacylglycerol acyltransferase 2 (DGAT2) in liver cells when it causes steatosis or the buildup of fat inside cells

However, it could also be a possible compensatory mechanism triggered by the HPA axis with increased cortisol secretion to mitigate the metabolic consequences of thyroid hormone deficiency (94)

In fact, it seems clear that the OCM (managed by vitamins B6 + B9 + B12) is crucial for AD and targeting it is one of the best strategy so far