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Medications know to cause bone marrow suppression (e.g., myelosuppressive antineoplastic agents) may result in a blunted or impeded response to methylcobalamin, vitamin B12 therapy

Low homocysteine could indicate an impaired ability to produce glutathione.[ref] People with Down syndrome may have three copies of the CBS mutation and subsequently very low homocysteine

Brown semaglutide indicates severe degradation, extended heat exposure, or both

Current evidence suggests women are more affected than men, partly due to higher rates of pre-existing iron deficiency