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This feature and its negative charge at physiological pH imply the existence of specific carriers to import GSH from the cytosol to the mitochondrial matrix, where it plays a key role in defense against respiration-induced reactive oxygen species and in the detoxification of lipid hydroperoxides and electrophiles

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Nevertheless, if we compare the internal states corresponding to Nrf2Keap1 complexes (Fig 3D), the dissociation model predicts an immediate decrease in the complex upon exposure to DEM followed by a sharp increase in complex formation, while the hinge-latch model predicts a prolonged increase in the complex that starts immediately upon oxidative stress

Providers might choose methylcobalamin first when neurologic or cognitive symptoms are presenteven when standard lab values dont appear drastically low