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If a patient does not respond to the first-line therapy (amitriptyline, cyproheptadine, and/or propranolol) the following options should be considered: (1) presence of persisting triggers (e.g., psychological stressors) and comorbid conditions (e.g., anxiety, POTS) or missed underlying disorders (e.g., hydronephrosis, chronic sinusitis, acute appendicitis, intestinal malrotation with volvulus, CNS tumors, metabolic crises) and toxic exposure (e.g., cannabis)

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It not only serves as a major risk factor for chronic diseases such as cardiovascular disease and diabetes but also exacerbates these conditions, further complicating their management and outcomes

It is a carnitine specific transporter that disappeared during evolution: it is present in mouse, but not in chimpanzee or humans (Pochini et al., 2013)

Impaired or incorrect activities of glutathione peroxidase (GPx), catalase, superoxide dismutase (SOD), and antioxidative compounds in the blood and decreases in the antioxidative capacity of the above-listed markers are frequently detected in ASD [36,37]