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in severe cases of late CTS when numbness is constant and patients may not still be waking from sleep, injection of cortisone is not a useful test

At the level of mitochondrial metabolic reprogramming, TMAO disrupts pyruvate and fatty acid oxidation, impairs electron transport chain function, reduces ATP synthesis, and induces energy metabolism disorders with concurrent ROS accumulation (Makrecka-Kuka et al., 2017)