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Citrate exported by SLC 25A1 serves not only as an intermediate in the TCA cycle but also as a precursor for fatty acid and sterol synthesis, glycolysis regulation, MAL production, and energy metabolism, as well as for epigenetic modifications via histone acetylation and other physiopathological processes ( SLC 25A1 are reported as homozygous, heterozygous, hemizygous, and frameshift alleles, which are strongly linked to the overproduction of both D and L -2HG ( SLC 25A1 activity and availability

However, this was not a controlled trial there was no placebo group, and the assessments were informal (patient surveys by phone)