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So far, the documented primary early PD metabolic pathway alterations include oxidative stress (significantly lower levels of dehydroascorbic acid than controls), carbohydrate metabolism (significantly higher levels of fructose, mannose, and threonine), lipid metabolism (e.g., sphingolipids or phospholipids), amino acid metabolism (lower levels of 3-hydroxyisovaleric acid and tryptophan and higher levels of leucine, isoleucine, and ketoleucine than controls), and fatty acid oxidation (lower levels of creatinine) (Wang J

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Physical symptoms may include weakness, pale or yellowish skin, numbness or tingling in extremities, balance difficulties, mood changes including depression or irritability, and tongue inflammation