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These toxins are known as endocrine disruptors that not only alter hormones, but can make it harder to live a healthy life with MTHFR since detoxification is already reduced to begin with

Radiology (1989) 173(1):236

Vitamin B12: an underestimated cause of acneiform drug eruption

MTRR activity can also be significantly impacted by heavy metals (including mercury) and nitrous oxide (in anaesthetics and laughing gas), reducing availability of methyl B12

Consequently, achieving effective clinical outcomes necessitates a multitargeted approach aimed at modulating the various actors and pathways contributing to its development

Yusuf S, Islam S, Chow CK, Rangarajan S, Dagenais G, Diaz R, Teo KK: Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey