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Under conditions of chronic stress or systemic inflammation, enzymes such as indoleamine 2,3-dioxygenase (IDO) and tryptophan 2,3-dioxygenase (TDO) are upregulated, diverting TRP metabolism away from 5-HT synthesis toward KYN production, with profound consequences for both peripheral physiology and central nervous system (CNS) function

Therefore, propofol is best considered a relative rather than an absolute contraindication to KD

It is commonly prescribed to prevent and treat Vitamin C deficiency and conditions such as scurvy, which is marked by weakness, anaemia, bleeding gums, and delayed wound healing