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Once severe sepsis is advanced, the physiology is much more oxidised, receptors may be impaired, and the situation becomes harder to reverse

SULT1B1 is similar to SULT1A1, but it is much more abundant in the intestine than the liver

[DOI] [PMC free article] [PubMed] [Google Scholar] 85

This localized hypoxia (lack of oxygen) forces cells to switch to anaerobic energy production, generating excessive lactic acid and causing rapid, severe muscle fatigue even after minimal physical exertion

It affects multiple organ systems including the respiratory, cardiac, hematological, neurological, renal and gastrointestinal structures