Since problems appeared only after glycogen was depleted, it must be a problem in gluconeogenesis, and not glycogen utilization. Since the conversion of glucose to lactate was normal, it must be one of the 4 reactions peculiar to gluconeogenesis that is defective. Many cancer cells have an increased rate of glycolysis compared to normal cells from the same tissue. This causes a diversion of metabolism from oxidative metabolism to glycolysis. The immediate administration of nitrite is an effective treatment for cyanide poisoning.
Enough nitrite is added to oxidize only part of the total hemoglobin present.
Such uncoupling agents are no longer prescribed because some deaths occurred following their use. The uncouplers increase the permeability of the inner mitochondrial membrane to protons. This decreases the efficiency of oxidative phosphorylation, as some protons simply leak back through the membrane rather than being utilized for ATP synthesis. Because they are fat soluble, these uncouplers tend to accumulate in the body fat rather than being excreted. A fatal concentration will decrease the ATP supply lower than is necessary to maintain life.