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The entire value of the physician-supervised compounding pathway is that a licensed provider sets your protocol based on your individual health history, goals, and response

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In the transulfation pathway, homocysteine is condensed in the presence of enzyme cystathione -synthase (CBS) with serine and a vitamin B6 cofactor to form cystathionine, which then may be converted to cysteine via enzyme cystathione -lyase (CSE) and cofactor vitamin B6 or converted back to homocysteine via enzyme cystathione -lyase (CBL)

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These therapeutic approaches are currently regarded as experimental and off-label, and patients should be fully informed of the limited empirical support for their efficacy and safety in these contexts