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Mitochondrial glutamate generated via these catabolic pathways can be exported from mitochondria to the cytosol through the SLC25A18 and SLC25A22 transporters 21 , and cytosolic glutamate then participates in the biosynthesis of glutathionea tripeptide comprising glutamate, cysteine, and glycineand NEAAs (alanine, proline, aspartate, asparagine, and arginine) and is used as an exchange factor for importing extracellular cystine via SLC7A11

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Table 5 showed that in the CT group, mental fatigue did not change significantly, while physical and fatigue severity score significantly increased after modified fasting therapy