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This approach balances therapeutic benefits against theoretical concerns about long-term continuous use, for which we lack human safety data

It is used to treat and prevent vitamin B6 deficiency resulting from poor diet, certain medications, and some medical conditions

Drugs such as carvedilol, lidocaine, propafenone, and verapamil exhibit reduced clearance and prolonged half-life, necessitating dose reductions of 23 fold in moderate to severe liver disease (11)

You can find genetic testing with various companies such as 23andme.com Its estimated that those with one mutation (heterozygous) decrease their ability to methylate by 30% and those with two mutations (homozygous) decrease their ability to methylate by 70%, making it virtually impossible to get adequate B12 from diet alone (19)

More recently, in view of the drawbacks of 4cB12, refined models have been developed based on "missing" biomarkers