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One of the primary reactions of methylcobalamin in the body is to convert homocysteine to methionine high homocysteine levels are undesirable and known to be an indicator of heart disease and stroke risk due to the fact free homocysteine in the blood causes sclerosis of the arteries, putting strain on the vascular system and the heart
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But the same reviews analysis found only baseline pulse significant in that subgroup, with BMI and BMI-by-dose interactions not significant predictors, so body composition is not established as the mechanism and the FDA calls the mechanism unknown
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