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Because MMACHC is the convergence point that processes all incoming cobalamin, its failure blocks synthesis of both coenzyme forms, so both homocysteine and MMA rise

Blood tests should, therefore, be focused on those able to confirm or diagnose an underlying disorder

Results: 313 patients were assessed by video between June 2023 and December 2024

For patients on bupropion, this conservative approach has merit because it reduces the likelihood of severe GI side effects that could lead to the dehydration and electrolyte imbalances that increase seizure risk