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Many patients have healthy homocysteine levels while also having impaired SAM:SAH ratios (impaired methylation capacity)

In most cases, the skin usually settles down within about a week

doi:10.1016/S0021-9258(19)77913-7 ^ a b Hyde C.C., Miles E.W

The fourth equatorial position is typically occupied by a water molecule, a hydroxide ion, or a fourth donor from the peptide depending on conditions

doi: 10.1210/jcem.80.4.7536210 95 GleesonHKLissettCAShaletSM