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J Endocrinol (1981) 89(2):27582.10.1677/joe.0.0890275 310 SheaBTHammerREBrinsterRL

doi:10.3389/fcell.2020.603837 63

This decrease in enzyme activity can lead to a buildup of a substance called homocysteine in the blood, which is associated with an increased risk of cardiovascular disease, stroke, and other health problems

Skipping intake means the clinic is not screening for contraindications (pregnancy, autoimmune flare, anticoagulant use, recent dental work, prior filler complications)