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Through proteomic analysis, we previously reported an upregulation of proteins involved in both beta-oxidation and the tricarboxylic acid cycle in patient-derived fibroblasts, with the possible purpose of increasing oxidative phosphorylation and, consequently, mitochondrial ATP production 26

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This is one indicator used to diagnose vitamin b12 deficiency, among other health conditions such as certain infections, kidney disease, liver disease, or HIV

This makes it particularly susceptible to oxidative stress

However, the full spectrum of probable adverse unfavorable effects remains unclear