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126,127 and (4) increased energy consumption due to increased gluconeogenesis, which is an energy-intensive process that costs ~400600 Kcal/day and the thermic effect of protein, which has the highest energy cost among all the three macronutrients (Fig

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Detoxification: In the liver, GSH is utilized by the enzyme Glutathione S-Transferase (GST) to bind, or conjugate , toxins (a key step in Phase II detoxification)

KPV also shifts macrophage polarization from M1 (pro-inflammatory, destructive) to M2 (reparative) without suppressing overall immune function

This interaction can lead to a decrease in the effectiveness of both the anticonvulsants and this medicine