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Choline, for example, is involved in lipid transport and metabolism (a vital part of energy storage), cell membrane signaling, and nervous system function
The compound is notoriously unstable once mixed with water: reduced glutathione (GSH) oxidises to glutathione disulfide (GSSG) within hours at room temperature, stripping the molecule of its electron-donating capacity and rendering it therapeutically inert
Optic nerve atrophy can worsen in patients whose methylcobalamin levels are already elevated
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