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Acute symptoms such as fatigue may improve within days, whilst neurological symptoms like paraesthesia typically require weeks to months of treatment

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TGA Chief Medical Advisor Robyn Langham says that's because compounded medications are exempt from the agency's usual checks and balances

In addition, the concentration of 5MTHF in the CSF is lower than normal in patients with idiopathic cerebral folate deficiency, and some patients also have reduced concentrations of CSF 5-hydroxyindoleacetic acid and biopterin