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The methionine remethylation step can be facilitated by several intermediates such as the well known reaction mediated by folic acid and its active metabolites to form 5-methyltetrahydrofolate (5-MTHF) creating tetrahydrofolate (THF) which will then regenerate to 5-MTHF through the action of methylenetetrahydrofolate reductase (MTHFR)

For example, one study compared 90 migraine patients with 90 matched healthy participants and found those with migraines, especially those with chronic (vs