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For example, BMAL1 directly controls transcription of enzymes involved in NAD + biosynthesis 4

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International recommendations for the Management of Adults Treated with ketogenic diet therapies

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The term impaired sensitivity to B12 more aptly captures this condition than functional B12 deficiency, encompassing a broader portrayal of the potential underlying pathological physiological process involving decreased responsiveness to B12 treatment, including B12 absorption, transport, intracellular metabolism, and mitochondrial MMA metabolism