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14.0% with placebo (difference, -19.4% [95% CI, -21.2% to -17.7%)

Homocysteine accumulation was reduced in response to Sal A treatment in hyperlipidemiathe activatory effect of Sal A on CBS activity In the transsulfuration pathway, CBS catalyzes the initial and rate-limiting step for homocysteine transsulfuration pathway [39]

Braz J Med Biol Res 45:546556 Schmidt-Sommerfeld E, Penn D, Kerner J, Bieber LL, Rossi TM, Lebenthal E (1989) Quantitation of urinary carnitine esters in a patient with medium-chain acyl-coenzyme A dehydrogenase deficiency: effect of metabolic state and l-carnitine therapy

Reducing oxidative stress by eliminating seed oils and supporting liver function amplifies results

Options include temporary nursing cessation with formula supplementation, microdose GLP-1 protocols (starting at $129/month) that minimize systemic exposure, or postponing treatment until weaning