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Bariatric surgery (including gastric bypass via Roux-en-Y or blind-loop intestinal bypass): Multifactorial, including systemic catabolism, steroid, tacrolimus, nutritional deficiencies (e.g., carnitine) investigation & monitoring investigation & monitoring interpreting the NH3 level This is discussed below in the treatment section

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Academic Press, London Boateng L, Ansong R, Owusu WB, Steiner-Asiedu M (2016) Coconut oil and palm oils role in nutrition, health and national development: a review

In the United States , the Food and Drug Administration (FDA) has not approved Melanotan II for any medical or therapeutic use