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High dose oral cobalamin would be a reasonable alternative as maintenance in patients unable to tolerate intramuscular injections provided there is good compliance with treatment

Notably, commonly used cell culture media (for example, DMEM, RPMI and F12) contain supraphysiological levels of cystine but lack GSH and cysteinylglycine

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Identifying these variants can guide dietary recommendations and supplementation with the appropriate form of folate

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