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The city has already spent more than $1 billion at the site over the past decade

While current clinical and anecdotal evidence hasnt shown an increased risk, caution makes sense, especially if you have a history of cancer or concerns about tumors

Overall, high lactate concentration promotes acidification of the TME and suppresses the immune system, thereby contributing to immune evasion and tumor growth, invasion, and migration

In older children or adults it may be considered if there are clinical symptoms suggestive of carnitine deficiency (hypotonia, lethargy), a significant decrease in the serum free carnitine levels, an impairment in hepatic function tests, or hyperammonaemia, even in the absence of VHE