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While the protective effect of folate against NTD is well established, only a few studies have investigated the role of other methyl group donors, including choline and betaine, in the occurrence of NTDs

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Dig Dis 2009;27:516-21

Concomitant medications may also contribute to musculoskeletal symptoms

Additionally, increased expression of xanthine dehydrogenase was associated with a better outcome for breast cancer patients