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Some newer liposomal and acetylated formulations improve bioavailability, but none reliably match the cellular delivery of a doctor-supervised IV protocol

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There are two 2HG enantiomers: D-2-hydroxyglutarate (D2HG) and L-2-hydroxyglutarate (L2HG), with the former predominantly generated from IDH1 mutants and PHGDH while L2HG is primarily generated from the promiscuous activity of LDHA and MDH1/2 under hypoxic or acidic conditions and converted back to 2OG by L2HGDH