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Although the exact cause of subnormal serum aminotransferase levels in CKD remains controversial, possible reasons are the severity of the impairment of renal function caused by glomerular dysfunction, pyridoxine deficiency and/or the presence of an inhibitory substance in uremia

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Veterinary J (2017) 221:5661

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Genetic mutations like MTHFR or nutrient deficiencies (B12, folate, magnesium) can slow methylation, reducing the bodys ability to eliminate toxins and repair tissues

Many people try over-the-counter painkillers or avoid triggers, but the pain often returns and may worsen over time