It takes several years to completely deplete your livers stores of B12, so people who have recently started a vegan or vegetarian diet may still have moderate vitamin B12 levels.[ref] Dietary sources: Foods that are highest in B12 include:[ref] beef liver mussels lamb caviar chicken livers High Homocysteine and B12: Homocysteine levels: If your homocysteine levels are high and you carry the MTHFR or MTRR reduced function variant above, supplementing with vitamin B12, methylfolate, riboflavin, and B6 may help to lower your levels.[ref][ref][ref] Interaction with alcohol: Alcohol is metabolized into acetaldehyde, which is toxic and inhibits methionine synthase (MTR)
The long-term effects, optimal dosing, and potential drug interactions are not fully understood
NMT nicotinamide N-methyltransferase Nicotinamide N-methyltransferase is a key enzyme located in the cytosolic milieu that catalyzes the transfer of methyl group from the co-factor S-(5-Adenosyl)-L-methionine (SAM) to substrates such as nicotinamide (NCA), pyridine, and related analogs, such as quinoline, isoquinoline, and the aliphatic amine 1,2,3,4 tetrahydroisoquinoline
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Some B12 products have aluminum, which can build up to harmful levels
