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Where both homocysteine and glutathione are unusually low, it may indicate impaired folate metabolism or reduced activity of enzymes involved in one-carbon metabolism, such as DHFR or MTHFR, rather than representing an ideal metabolic state

preprint: Desrochers et al , 2018)

Weeks 12: 2 mg once weekly Weeks 36: 4 mg once weekly Weeks 710: 8 mg once weekly Week 11+: 12 mg once weekly (if tolerated) Fast escalation: Select cases, monitored closely This fast-escalation schedule is used only in specific situations where close supervision is available, such as in specialty clinics or structured clinical trial settings that follow strict safety protocols

ICER has also estimated current net annual prices in the thousands of dollars for these medications, underscoring why long-term affordability is such a central issue

Because of this, its not a stretch to wonder if topical melatonin may also cause you to feel sleepy