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The standard titration schedule calls for increases every 4 weeks until you reach the dose that produces adequate results
doi: 10.1016/j.gendis.2024.101262 155 ZhangWLiuYLiaoYZhuCZouZ
This suggests that the overall rate of glucose metabolism is unaffected by methylene blue, but a greater proportion (87%) is by way of the decarboxylation pathway
It is not synthesized by the body and is therefore, described as essential and must be provided by the diet
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