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These indicators were also observed in conjunction with prototypical phenotypic features of ferroptotic cells including elevated cellular and mitochondrial ROS (56, 87, 153), excessive lipid peroxidation markers MDA (56, 87) and 4HNE (87), and altered mitochondrial ultrastructure including decreased volume and altered cristae organization (56, 87)

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The metabolism of R,S-BD AcAc diester produces a comparable rise in D-HB to that observed with ketone salts, but this ketone ester is accompanied by a significant rise in blood AcAc (~0.4 mmol/L)

The absence of specific guidance reflects the lack of robust clinical trial data in this population