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There is preliminary data suggesting that methylcobalamin by itself can cause an increase in SAH, leading to incomplete reconstitution of the methionine cycle

For example, muscle overuse-induced cysteine oxidation and its intermediate cysteine sulfinic acid oxidation result in a reduced level of taurine and glutathione synthesis (GSH), ultimately compromising the taurine-induced benefits in the muscle, such as influencing GSH level and glutathionylation (Qin et al., 2013)

Patients with one nonfunctional CYP2D6 null allele ( *3 , *4 , *5 , *6 , *52 , *4xn ) and one low activity CYP2D6 allele ( *9 , *10 , *29 , *41 ) were grouped as IMs, patients with one or two functional copies of the CYP2D6 gene were grouped as EMs