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In a randomized, double-blind, placebo-controlled trial in 2,919 participants (65 years) with elevated blood concentrations of homocysteine, supplementation with vitamin B 12 (500 g/day) and folic acid (400 g/day) for two years did not decrease the risk of osteoporotic fracture despite reductions in homocysteine (120, 121)

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7 The Genetics of Homocycsteine Metabolism Genetic variation (polymorphism) fundamentally impacts the activities of enzymes involved in homocysteine metabolism