The initiation of prion misfolding and propagation is not fully understood, with theories including viral bodies, micronutrient imbalances (e.g., copper and zinc), or spontaneous mutation.

“and there's there's been a whole ton of um sort of Investigations trying to figure out what what causes them like what might initiate the the misfolding uh and sort of propagation of these proteins like um is it you know are they actually just like viral bodies that can be transmitted in that way are they is it due to um like different micronutrients so there was there were some um there was some people who thought that maybe like a an imbalance between like the availability of copper and zinc may cause the proteins to be folded differently and that that that may cause it I don't think anybody really knows or if they do know that's not something that I've read in the literature recently”