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Thyroid Disease in Pregnancy.ACOG Practice Bulletin, Number 223

Interestingly, only the heart contains significant amounts of L-stereoisomer of -OHB (Tsai et al., 2006) but its physiological role is unclear

however, it important to highlight the condition since clinicians may need to request further investigation to determine its cause

Mitochondrial dysfunction may further promote the release of Fe, intensifying the Fenton reaction and generating more OH, thereby amplifying intracellular oxidative stress