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Positional techniques: Sit upright for 1-2 hours after eating (lying down worsens reflux and nausea) Sleep with upper body elevated 30 degrees (extra pillows or wedge pillow) Avoid bending over or tight waistbands (increases gastric pressure) Gentle walking after meals (helps gastric emptying without jarring movement) Breathing techniques: Slow, deep breathing through nose

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SAM is additionally required for phosphatidylcholine synthesis, which is abundant in neuronal membranes and is crucial for synaptogenesis and neurite outgrowth ( Vitamin B12 is a cofactor for the enzyme methylmalonyl-CoA mutase, which converts methylmalonyl-CoA to succinyl-CoA, a crucial step in fatty acid metabolism (73)