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In: Adashi E.Y., Mancuso S., editors

These metabolic changes can limit the work capacity of skeletal muscle, since the accumulated acetyl-CoA inhibits the activity of pyruvate dehydrogenase [64]

This authoritative observation cements the understanding that POTS and related autonomic disorders are not simply mechanical circulatory issues, but are deeply rooted in underlying metabolic and mitochondrial deficits that require targeted nutritional intervention to resolve

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