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Consequently, its clinical relevance is profound: it provides a mechanistic explanation for the heterogeneous treatment response observed in practice and introduces a measurable pathological processdysregulated lactate metabolismthat can be therapeutically targeted [93]

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Think of it this way: Methylmalonic acid (MMA) is a metabolic byproduct that accumulates in the body when there isn't enough active vitamin B12 to break it down

In other words, the cleansing out or releasing of toxic molecules is impaired by the presence of mercury