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The vitamin supplements, but not the placebo significantly reduced all 4 metabolite concentrations (methylmalonic acid, homocysteine, 2-methylcitric acid and cystathionine)

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Baseline and periodic liver function tests (LFTs) are recommended, with closer surveillance in patients with preexisting hepatic impairment

Exaggerated Claims: Be wary of claims of extremely high concentrations (e.g., 8%) without proper formulation, or promises of "overnight miracles." No Third-Party Testing: Lack of an independent COA means purity and concentration are unverified