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But why has no synthetic pathway evolved that leads directly to the synthesis of L-malate

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It is well known that morphine can markedly lower GSH and cysteine levels in brain and peripheral tissues 109,110,111,112,113,114,115,116,117

Concurrent nutritional deficienciesparticularly folate or iron deficiencycan impair the response to B12 treatment, as these nutrients work together in red blood cell production