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It depends on how bad the deficiency is and how well you respond

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Homocysteine levels above 15 micromoles per liter indicate B12 metabolism problems that standard serum tests miss completely

Results are usually best among those who combine medication with diet and exercise

The compound has since been studied in cartilage and osteoarthritis research and remains in active use as a research tool for investigating 3-AR-mediated lipid metabolism

In those patients, addressing the underlying metabolic dysfunction first, through dietary intervention, GLP-1 therapy if indicated, or NAD+ support for cellular energy metabolism, is the clinical priority