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Winkler L, Offner G, Krull F, Brodehl J (1993) Growth and pubertal development in nephropathic cystinosis

This adaptability allows the heart to regulate the utilization of different energy substrates according to its needs, maintaining normal cardiac function and ensuring a continuous supply of ATP (34, 50)

Anything less than that, and you are stacking active drug on top of active drug in a way your body was never meant to handle