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Also, ask about managing side effects and dietary choices during treatment

After the 12 cm of insertion, stop further needle advancement and make subtle probe adjustments until the needle is visualized

doi: 10.1016/j.niox.2010.10.002

[35] The reaction begins with the nucleophilic attack by the C-2 carbanion on the carbonyl carbon of pyruvate, which has the oxidation state of an aldehyde, leading to the formation of a covalent bond between the coenzyme and pyruvate