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In addition to alanine, a standard blood biomarker in MDs (Shaham et al., 2010), patients with primary mitochondrial respiratory chain disease also have significantly elevated levels of BCAAs (Clarke et al., 2013)

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As such, even though the FDA has not approved its use, we can assume that some adults are already taking it

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Deficiency can occur in certain populations, including older adults, vegans, individuals with pernicious anaemia, those with malabsorption disorders such as Crohn's disease or coeliac disease, people who have had bariatric surgery or gastrectomy, and those on long-term medication such as metformin or acid-suppressing drugs