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The two reasons are that CBS is activated by estradiol and betaine (Bet), which is twice as high in females compared to males because the enzyme PEMT [Figure 1] is activated by a factor of 2.3 in menstruating females

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Your body produces it on its own, but production declines significantly with age, from roughly 200 ng/mL at age 20 to around 80 ng/mL by age 60

Engl J Med

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A byproduct of this metabolically intensive process is creation of free radicals