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While these anecdotes can be compelling, they don’t account for natural recovery, placebo effects, or individual variation—which is why they sit firmly at the bottom of the evidence hierarchy

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Impaired activity of methionine synthase results in elevated blood concentrations of homocysteine, while impaired activity of L-methylmalonyl-CoA mutase results in increased concentrations of a metabolite of methylmalonyl-CoA called methylmalonic acid (MMA) in blood and urine