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We strongly recommend it, but no - you do not have to have one if you choose not to, though we do explain why this is storngly recommended

Even if clinical trials suggest tolerability, the real-world risk profile changes when: the source and purity of the peptide are uncertain, its used in different routes than studied, its used in stacked protocols with other drugs, its used in populations the trials didnt represent

L-methymalonyl-CoA mutase converts L-methymalonyl-CoA to succinyl-CoA, which is essential for the metabolism of protein and fat