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Objective physiological data gathered from skin biopsies in this same study showed that after approximately six months of targeted supplementation with L-methylfolate, methylcobalamin, and pyridoxal 5'-phosphate, 73% of the patients demonstrated a measurable increase in calf epidermal nerve fiber density

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Follow up of the HAM-D score was recorded during 12 weeks by a research officer who was unaware of the patients randomization

While these side effects are relatively rare, they highlight the need for thorough clinical evaluations and monitoring