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After reviewing literature and conducting a two-round Delphi survey with 42 experts, a consensus emerged that emphasizes prioritizing clinical symptoms in diagnosis, with serum B12 as a screening marker supported by methylmalonic acid or homocysteine levels for additional confirmation

Public comment opportunities exist during PCAC review cycles, and physician-clinical-experience testimony can meaningfully inform the regulatory record

Being a peptide, Glutathione is prone to enzymatic degradation and poor gastrointestinal absorption

Follow 28-30 day rule if using research peptides