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If one or more of the three are low, I want to know whether that deficiency is translating into elevated homocysteine levels, because that changes how I think about the patient’s overall clotting risk

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However, the more honest metric is cost per effective dose , and here oral's lower and more variable systemic bioavailability complicates the picture: if a larger oral dose is needed to achieve a comparable systemic effect, the apparent per-milligram savings shrink