MTO1 and hyperinsulinemic hypoglycemia, familial, 4: Since the first diagnosed case of MTO1 deficiency in 2012, many cases have been trialled on several therapies such as L-carnitine, coenzyme Q10, vitamin C, riboflavin, thiamine, dichloroacetate (DCA) and/or vitamin E. Despite the use of multiple variations of this “mitochondrial cocktail”, documented objective improvement was rare.