Joan, a smart 17-year old, has phenylketonuria due to phenyl hydroxylase deficiency. She has been on a very strict low phenylalanine diet ever since she was 10 days old. The diet, a synthetic mixture of amino acids and other nutrients, is very unpalatable and she would like to get off it. She does not respond to tetrahydrobiopterin. She is strongly advised against getting off the diet because:
- A. If she were to get pregnant, elevated phenylalanine in her blood would cause birth defects in the fetus.
- B. Her dihydrobiopterin reductase is not functioning well
- C. Elevated phenylalanine may damage her brain and reduce her IQ
- D. B and C
- E. A and C