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At pH 5.7, the histidine imidazole (pKa ~6.0) remains predominantly deprotonated and available for copper coordination

Functional improvements generally become noticeable during weeks 2 to 4

In addition to the amino acid changes we saw a significant increase in 2-aminoadipic acid, which is produced by lysine degradation

The actual benefit is narrower and more honest: correcting an existing deficiency can restore energy levels and general well being, which indirectly supports a healthy weight through better activity and mood, not through a direct metabolic effect

The shorter course at higher per-day dose suits patients who prefer fewer total injection days