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One of the by-products of SAM-e's methyl donation is, in fact, s-adenosylhomocysteine (SAH), which does become homocysteine. Given appropriate levels of folate, B6, B12, and SAM-e, this will be remetabolized into more SAM-e. The only risk of increased blood homocysteine concentrations would occur in patients who were extremely folate deficient and who were taking extremely high amounts of SAM-e.
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Will taking a product containing SAM-e raise my patients' blood homocysteine concentration?
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