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10.1017/S0029665108007052 207

It should be noted that although a growing number of studies have shown that amino acid metabolic reprogramming is widely present in the inflammatory microenvironment of multiple autoimmune diseases and is closely associated with the functional states of macrophages, current evidence also suggests that, in most diseases, alterations in amino acid metabolism are not necessarily primary drivers of disease onset, but may more likely reflect metabolically adaptive changes during immune cell activation and polarization

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I felt a little woozy the morning after the shot but otherwise was fine until day 5 when my low back/sacrum started hurting, tender to the touch, hurt to bend, stand, walk, then two days later it moved to my lumbar spine-very stiff, tender, feels like bones more than muscles as it hurts to use the foam roller on the vertebrae