Background: Propionic acidemia (PA) is an inborn error of metabolism (IEM) that typically presents in the newborn. The Amish of North America have an increased prevalence of PA due to a founder variant in the PCCB gene. The Amish PA phenotype is variable. and some individuals remain asymptomatic and undiagnosed until adulthood. https://parisnaturalfoodes.shop/product-category/ramen-mushroom/