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High homocysteine levels are problematic because they have been linked to heart disease and atherosclerosis.32 In people who are deficient or have mutations in the enzymes that catalyze the production of glutathione from homocysteine, the methylation cycle will be under pressure to remove excess homocysteine

The upper arm site should only be used when adequate subcutaneous tissue is present, as insufficient tissue depth may result in inadvertent intramuscular injection, potentially altering absorption kinetics

A Mendelian randomization study found a causal relationship between TMAO and its precursors and susceptibility to hypertension

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