When people with SCAD fast or do not eat for a relatively long period of time, the body tries but fails to break down these short chain fatty acids, which can result in low blood sugar, low energy, liver or muscle injury, or coma with possible permanent brain damage. This is known as a metabolic crisis. When people with SCAD are sick, such as when they have the flu or cold, they eat less and they are more likely to have a metabolic crisis.