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More specialized markers such as methylmalonic acid or homocysteine, which can clarify borderline cases, also take weeks to shift

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Beyond MTHFR, polymorphisms in genes encoding drug transporters, such as SLC19A1 (rs1051266) and SLCO1B1 (SLCO1B15 and SLCO1B115), have been implicated in MTX transport efficiency and toxicity profiles