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Patients should be clearly informed of these limitations before considering either treatment

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Additionally, a randomized, double-blind, placebo-controlled trial in 2,588 healthy older adults with mild hyperhomocysteinemia found that daily supplementation with 500 g of vitamin B 12 and 400 g of folic acid for two years reduced blood homocysteine concentrations but had no benefit on depressive symptoms in those with or without depressive symptoms at baseline (110)

The 14.9% efficacy ceiling at the approved dose is nearly 10 percentage points below what Retatrutide achieves