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[PubMed | ClinicalTrials.gov | DOI] Davies M, Frch L, Jeppesen OK, et al

The mechanism is dual-action

Remethylation requires folate and B12 coenzymes while transsulfuration requires pyridoxal-5-phosphate, the B6 coenzyme

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Where neurological symptoms are present, loading runs 1mg on alternate days until there is no further improvement, which is a presentation that belongs with a GP or specialist rather than a wellness clinic