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Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thrlimann B, et al

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If homocysteine is not efficiently converted back to methionine or diverted into the transsulfuration pathway, it accumulates in plasma, a condition known as hyperhomocysteinemia

While this acute effect has been studied primarily in the context of cardioprotection research, any acute hemodynamic modulation carries theoretical safety implications in research models involving compromised cardiovascular function

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however, by week 12, the IGF-1 group did not exhibit any additional therapeutic advantages