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glutathione is needed to help neutralize toxins in the liver

In 13 of 15 patients with baseline B 12 levels, they were 250 pg/mL or below (ranging from 57 pg/ mL to 238 pg/mL)

[6] SAM may act as a methyl donor in the metabolic processes that control lipid homeostasis, DNA stability, gene expression, and neurotransmitter release, which may account for the benefits it confers

Additionally, chronic conditions such as HIV and tuberculosis have been implicated in B12 deficiency due to increased metabolic demand and altered absorption mechanisms ( The diagnosis of vitamin B12 deficiency typically relies on low total B12 levels and elevated concentrations of homocysteine (Hcy), as well as levels of transcobalamin-bound B12 (holoTC) and methylmalonic acid (MMA), which serve as functional indicators of cobalamin insufficiency ( Vitamin B12 requirements fluctuate throughout the life course, influenced by metabolic demand and physiological changes