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Unusual hormonal status can lead to the inability of ovaries to release functional and mature follicles

doi: 10.1016/j.taap.2017.12.007

Increased levels of serum fatty acids and hydrophobic bile acids lead to impaired mitochondrial function ( Reference Chang, Argo and Al-Osaimi 24 )

Amino Acids 41:507515 Bellinghieri G, Savica V, Mallamace A, Di Stefano C, Consolo F, Spagnoli LG, Villaschi S, Palmieri G, Corsi M, Maccari F (1983) Correlation between increased serum and tissue l-carnitine levels and improved muscle symptoms in hemodialyzed patients

While less effective, they provide a baseline option that is always accessible regardless of insurance decisions, pharmacy stock levels, or regulatory changes