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Methylcobalamin facilitates the conversion of homocysteine to methionine, reducing neurotoxic homocysteine levels by 30-40% (NIH 2025 longitudinal study, n=1,200 elderly, aged 65-85)

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While the TECOS trial reported neutral cardiovascular effects for sitagliptin, other agents like saxagliptin are associated with increased HF hospitalization risk (78)