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. 2021 Nov 11;14(11):e245012. doi: 10.1136/bcr-2021-245012

Figure 1.

Figure 1

The role of the catechol-O-methyltransferase (COMT) enzyme in norepinephrine inactivation. Based on this pathway, we suggest that impaired function of the COMT enzyme can lead to increased levels of norepinephrine. This pathway is further dependent on adequate levels of cofactors including vitamins B6, B9 and B12. *Low levels of product. SAM, S-adenosyl-L-methionine; SAH, S-adenosyl-L-homocysteine.