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In the majority of OAD the organic acid accumulates due to deficiency in the mitochondrial catabolism of various CoA-activated carbonic acids such as propionyl-CoA, methylmalonyl-CoA, isovaleryl-CoA, and glutaryl-CoA

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This matters for peptide therapy because: Peptide responses differ by gender (women often need different dosing and timing) Peptides must be integrated with sex hormone optimization (testosterone for men, estrogen/progesterone for women) Menstrual cycle considerations affect peptide protocols for women Couples can receive coordinated care with provider continuity 4

Receptor potency: Extra nine-amino-acid tail boosts binding affinity

doi: 10.1016/j.jad.2024.07.033 116

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