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L-glutamine is a conditionally essential amino acid in SCD that: Increases NAD levels through de novo synthesis Serves as a precursor to glutathione, the primary antioxidant in red blood cells Replenishes the NADH/NADPH pool to support cellular energy and oxidative balance Clinical evidence is robust: a Phase 3 randomised controlled trial (Niihara et al., 2018, N=230) demonstrated a significant reduction in painful crises and fewer hospitalisations in SCD patients receiving oral L-glutamine results that led to FDA authorisation for L-glutamine powder to reduce acute SCD complications in patients aged 5 years and older

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