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27 Competition in the distribution of 5,10-methyleneTHF between thymidylate biosynthesis and remethylation pathways indicates that common MTHFR variants (C677T and A1298C) may also alter activity of the multienzyme complex in thymidylate production during DNA repair

Meta-analyses find it improves cognition in mild cognitive impairment and early Alzheimers, with one review putting the benefit at roughly four to twelve weeks per course, longer than a nootropics washout and shorter than a durable structural change, and it usually needs maintenance