Vitamin B12, folate, and vitamin B6 are involved in homocysteine metabolism. In the presence of insufficient vitamin B12, homocysteine levels can rise due to inadequate function of methionine synthase [ 6 ]. Results from several randomized controlled trials indicate that combinations of vitamin B12 and folic acid supplements with or without vitamin B6 decrease homocysteine levels in people with vascular disease or diabetes and in young adult women [ 59-67 ]. In another study, older men and women who took a multivitamin/multimineral supplement for 8 weeks experienced a significant decrease in homocysteine levels [ 68 ].
Some bodybuilders and athletes use trenbolone for its muscle-building and otherwise performance-enhancing effects. [ citation needed ] Such use is illegal in the United States and many other countries. The DEA classifies trenbolone as a Schedule III controlled substance under the Controlled Substances Act .  Trenbolone is classified as a Schedule 4 drug in Canada  and a class C drug with no penalty for personal use or possession in the United Kingdom .  Use or possession of steroids without a prescription is a crime in Australia .  The infamous "duchess" cocktail administered to Russian athletes at the Sochi Winter Olympics consisted of oxandrolone , metenolone , and trenbolone.