If levels do not correlate well, consider either dosing solely based on free phenytoin levels (if these can turn around rapidly enough) or avoiding phenytoin altogether
Plasma levels of homocysteine depend on several factors, such as genetic alteration of methionine metabolism enzymes or deficiency of vitamin B12, vitamin B6 or folic acid [18]
[DOI] [PMC free article] [PubMed] [Google Scholar] 52.zer A., engel N., Kk A., Yman Z., zdemir ., Kl Y., Dursun A.D., Bostanc H., Kip G., Arslan M., et al
Proton pump inhibitors reduce gastric acid production, which impairs the release of food-bound B12 but has less effect on synthetic B12 in supplements
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