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Sadenosylmethionine (SAM), a precursor to methionine, has been produced

Conversely, it may enhance the renal excretion of some drugs, such as amphetamines and certain tricyclic antidepressants, by acidifying the urine

You have megaloblastic anemia and are pregnant

A Comprehensive Overview of Subacute Combined Degeneration: MRI Diagnostic Challenges and Treatment Pathways
