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Inhibiting the activity of system Xc- affects the synthesis of GSH by inhibiting the absorption of cystine, which leads to a decrease in GPX activity, a decrease in cell antioxidant capacity, accumulation of lipid ROS, and ultimately the occurrence of oxidative damage and ferroptosis

Hydroxocobalamin 1mg is the standard UK formulation, typically administered every two to three months for maintenance therapy Self-administration requires GP prescription, competency training from practice nurses, and demonstration of proper injection technique Common injection sites include the thigh (vastus lateralis) for both intramuscular and subcutaneous administration with site rotation essential Serious side effects are rare but anaphylaxis requires immediate 999 call

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Creatine phosphate provides the rapidly available ATP buffer that supports the high-intensity exercise most likely to upregulate endogenous MOTS-c

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