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There are two 2HG enantiomers: D-2-hydroxyglutarate (D2HG) and L-2-hydroxyglutarate (L2HG), with the former predominantly generated from IDH1 mutants and PHGDH while L2HG is primarily generated from the promiscuous activity of LDHA and MDH1/2 under hypoxic or acidic conditions and converted back to 2OG by L2HGDH

Important things to remember include: How to handle and throw away syringes Preparing the injection site right Safe ways to inject to avoid problems Monitoring Response and Adjusting Treatment Its important to watch how youre doing with vitamin B12 shots

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