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Severe MTHFR deficiency Patients with severe MTHFR deficiency typically have severe hyperhomocystinuria (greater than 100umol/L), hypomethioninemia, decreased circulating folate, decreased CH3-tetrahydrofolate, and decreased neurotransmitters (1)

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A clear integrative gap remains in linking the pathophysiological progression of G-LOC with multimodal monitoring indicators, individualized state assessment, and mechanism-informed protective strategies within a coherent physiological framework