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Studies published in prestigious medical journals, including the Annals of Internal Medicine and the Journal of the American Medical Association , have shown that physicians can lag behind the latest research by an average of 17 years

Hum Mol Genet 2016;25:34763490

This can cause methyl trapping, where the excess methylfolate is unable to be utilised in the methionine cycle (through the MTR enzyme) as usable B12 levels are too low

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