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A large 24-week trial involving 536 participants failed to demonstrate statistically significant weight loss compared to placebo when combined with diet and exercise

Springer Science & Business Media Boushey CJ, Beresford SA, Omenn GS, Motulsky AG (1995) A quantitative assessment of plasma homocysteine as a risk factor for vascular disease

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Studies show certain derivatives exhibit enhanced neuroprotective effects through stronger binding to therapeutic targets and improved cellular uptake [126]

Other general confounding factors noted in patients of these studies include but are not limited to obesity, alcohol, nicotine, or marijuana