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Treatments are not substitutes for lifestyle modification

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Dose optimization requires baseline biomarker testing and provider oversight to ensure efficacy and safety

Circumstantial evidence for this hypothesis comes from one cohort study in which the combination of low B12 and high folate status was associated with lower serum holotranscobalamin concentrations than when B12 was low but folate was not elevated (81)

Human B-Dependent Enzymes: Methionine Synthase and Methylmalonyl-CoA Mutase