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As per this research, the primary treatment method is supplementation with vitamin B12

In unclear cases, methylmalonic acid and homocysteine levels may be measured

As a permanently charged quaternary cation the compound is water-soluble and requires no organic cosolvent for aqueous work, though DMSO stock solutions are common in cell-based screening

This includes nicotinamide riboside kinases, nicotinamide phosphoribosyltransferase, and other methyltransferases that could confound experimental results

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