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Common (PN-related) Nausea Vomiting Mild fever or infusion discomfort Elevated BUN (from total nitrogen load) Hyperglycemia (PN carbohydrate component) Electrolyte abnormalities Proline-Specific Considerations Hyperprolinemia (rare without metabolic disorders) Symptoms may include: Neurologic changes Seizures (in genetic metabolic disorders) Cognitive alterations Amino-acid imbalance if hepatic metabolism impaired Severe (rare) Anaphylactoid reactions to amino-acid solutions Liver dysfunction with long-term high-dose PN Metabolic acidosis from improper PN formulation Refeeding syndrome (phosphate, potassium, magnesium shifts) Pregnancy & Breastfeeding Pregnancy Proline is a normal nutritional requirement and is safe when delivered as part of PN

Additional symptoms during this phase include: Abdominal pain Inability to speak or move Diarrhea Slightly elevated temperature Dizziness Headache Sensitivity to light Drowsiness Drooling or excessive saliva Recovery Phase : The vomiting, retching, and nausea gradually subside, and other symptoms improve

5.3 Oral ketones Oral ketone supplements can be divided into ketone salts and ketone esters, but ketone salts are not suitable for long-term oral consumption due to their high sodium content

108,109 Refer to Life Extensions Weight Management protocol for more information

Pelletier et al., 2015)

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