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238,242 Isocitrate dehydrogenase 3 (IDH3), a pivotal rate-limiting enzyme in the TCA cycle, is downregulated, leading to oxidative phosphorylation uncoupling and lactate accumulation in the brains of AD patients and AD transgenic mice

So a patient on a 0.25 mg starter dose draws 25 units per week that is roughly 20 weekly doses per vial

In conclusion, metabolic reliance on glutamine arises via the intrinsic functional diversity of glutamine, supporting macromolecule biosynthesis and reinforcing the TCA cycle