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High MCH can be a marker for low B12 (and folate) Elevated MCH (Mean corpuscular hemoglobin) value can be caused by anemia due to B12 and folate deficiencies

S-adenosylmethionine regulates MAT1A and MAT2A gene expression in cultured rat hepatocytes: a new role for S-adenosylmethionine in the maintenance of the differentiated status of the liver

Moreover, L-Carnitine suppressed genes responsible for protein degradation in skeletal muscle [17] and decreased muscle RING-finger protein-1 ( MuRF1 ) and ubiquitin-protein conjugates, involved in protein catabolism, as well as increases the levels of IGF-1 and Akt1, two upstream elements in the mammalian target of rapamycin (mTOR), the main driver of protein anabolism [18]

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On this basis we to evaluate the possible impact of long-term administration (6 months) of a combination of low doses of carnitines, L-ARG and NAC on hormonal and metabolic parameters and on the hepatic insulin extraction index (HIE) in a group of obese PCOS patients