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The most detrimental clinical presentation is fulminant liver failure, where patients without a history of liver disease present with hepatic encephalopathy and coagulopathy preceding jaundice

As MTHFR polymorphisms-induced MTHFR activity decline is irreversible, clinicians tried to use supplement of folate to help methylation process and change the pathogenesis state

10.1038/s41467-024-51079-1 Nat Commun

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blood, urine) are derived by statistical methods from surveys and repeated measures of chemicals, and further used by the German HBM Commission to define concentrations (HBM-I and HBM-II) with no increased risk for adverse health effects or with the need for intervention to reduce an exposure (Umwelt Bundesamt, 2023)