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Abstract Glutathione synthetase deficiency (GSSD) is an autosomal-recessive metabolic disorder caused by glutathione synthetase ( GSS ) gene mutations

These might include: Persistent fatigue that seems disproportionate to liver disease severity Glossitis (sore, red tongue) or mouth ulcers Shortness of breath and palpitations due to anaemia Difficulty concentrating or 'brain fog' Mood disturbances including irritability or depression It is crucial to recognise that some symptomsparticularly fatigue and cognitive changesare common in both fatty liver disease and B12 deficiency, potentially leading to delayed diagnosis

This can mislead both the patient and the treating doctor into thinking vitamin B12 was not the issue

Comparing method means eliminates the bias of 14 group contribution methods against 6 or fewer values by the other methods

A Systematic Review of Nutraceutical Interventions for Mitochondrial Dysfunctions in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome