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Tarleton, A., Berven, S., Vaccaro A.R..: Preoperative Considerations for the Adult Deformity Patient. The Spine: Medical and Surgical Management, by Alexander R

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At the same time, proton secretion in the collecting duct is increased which helps ammonia to be converted into ammonium and then be trapped into the tubular lumen
Certain medications: It is important to note that certain medications, including methotrexate, have been known to raise homocysteine levels

Imbalanced or rapidly changing neurotransmitter levels can lead to changes in mood and behavior
