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A theoretical concern is that increasing glutamine availability might stimulate tumor growth, but it is not clear whether well-perfused tumors ever experience glutamine deprivation in vivo , and one study in sarcoma-bearing rats found no enhancement of tumor growth when the animals’ diet was supplemented with glutamine (Klimberg et al

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Second, OS activates the polyol pathway, depleting NADPH reserves and reducing glutathione levels, leaving nerves vulnerable to lipid peroxidation—a process evidenced by 3-fold higher levels of 4-HNE in sural nerve biopsies from diabetic patients with neuropathy compared to controls (Pop-Busui et al., 2016)