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The risk is greatest among infants who are fed formula low in biotin, people taking antiepileptic medications, infants with Leiners disease or people who are genetically predisposed to deficiency ( Untreated biotin deficiency can cause neurological symptoms, such as seizures, intellectual disability and loss of muscle coordination ( Deficiency has also been reported in animals fed high amounts of raw egg whites

10.1056/NEJMoa2204233 31 TuttleK

Mechanistically, acetyl-CoA, a derivative of BCKAs, inhibits the interaction between PR domain-containing protein 16 (PRDM16) and peroxisome proliferator-activated receptor- (PPAR-) by acetylating the k915 site of PRDM16 to maintain WAT characteristics

Rahman SU, Huang Y, Zhu L, Feng S, Khan IM, Wu J, et al

If you've used injectable medications before, vial use is straightforward