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Almost none are aware because they operate under the assumption of undernutrition of X nutrient with All co-factors being available.I wonder how many doctors are aware of cofactor issues. If a patient has a bad reaction to a supplement, I think in many cases the doctor will write that patient off as having psychological issues, because the doctor knows that "Nutrient x is good for you!". The expected responses to supplements are based on healthy people. People go to the doctor when they are unhealthy, meaning possible abnormal biochemistry.
Its a highly erroneous view but a common one nonetheless. Acknowledging cofactors makes treatment significantly more complicated when they’re trying to get someone out the door as quick as possible.