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Thus, the extraordinarily high phosphoryl-transfer potential of PEP is due primarily to the subsequent enolketo tautomerization of pyruvate, which provides a strong thermodynamic driving force

Reference Kampranis, Damianova, Atallah, Toby, Kondi, Tsichlis and Makris2000)

Beyond that, methyl groups donated through the methylation cycle land on DNA itself, which is how the body controls gene expression turning genes on and turning genes off

However, most pediatric trials to date have been small, open-label, and lacked long-term follow-up

doi:10.1002/jimd.12009

Dosage varies depending on treatment goals and physician recommendations