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Furthermore, these toxic lipid products can react with nucleophilic amino acid residues within various proteins, forming covalent adducts and inducing protein lipoxidation [107]

Angiogenic signaling and macrophage recruitment have been proposed as contributing mechanisms

But theres a formidable gatekeeper in this process: Insulin

Supplemental folic acid use at the higher end of this suggested range has been recommended by some in order to ensure a minimum RBC folate concentration of 906 nmol/L (32) after four weeks of supplementation (30, 33), which would maximize NTD risk reduction particularly for those with low folate status

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