Supplement Doses, Formulation and Administration Targeted metabolic support is based on metabolic evidence of oxidative stress and/or impaired methylation capacity. The supplements will be in the form of methyl B12 pre-loaded syringes (previously approved by UAMS IRB [protocol #28839] and the FDA [IND # 71459]), small capsules (folinic acid and carnitine), powder (minerals and antioxidants), and a liquid (cod liver oil and essential fatty acids). The placebos (cellulose) will be prepared in identical form by Kirkman Laboratories. The Methyl B12 pre-loaded syringes and placebos will be prepared in identical form by Custom Compounding Pharmacy