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Challenges Due to its well-established role in neural tube development, folic acid supplementation is recommended in clinical guidelines (US Preventive Services Task Force, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, American Academy of Pediatrics, and the Center for Disease Control and Prevention) for those who are planning to or could become pregnant (Force et al., 2023)

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Large amounts of niacinamide may increase the risk of liver problems when combined with alcohol or statin cholesterol drugs