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It is produced by the liver and is involved in functions such as tissue building and repair as well as supporting the immune system

[5] Disruption of these pathways leads to accumulation of homocysteine and methylmalonic acid, metabolic signatures linked to megaloblastic anemia and demyelinating neuropathy

When it begins to decline during perimenopause, it can trigger hunger and cravings and potentially lead to weight gain

Another drug in this class, pioglitazone (Actos), is still available