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A pivotal 2009 study published in Neuro Endocrinology Letters by Maes et al

Often used as a diet protein supplement to help serious weight loss or bodybuilding.

Symptom improvement is seen in a subset of patients, but the majority show no improvement or worsening of symptoms despite treatment or attack resolution

Trimethoprim is metabolized in vitro to 11 different metabolites, of which, five are glutathione adducts and six are oxidative metabolites, including the major metabolites, 1- and 3-oxides and the 3- and 4hydroxy derivatives