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Additionally, it significantly increases the lipid peroxidation and reactive oxygen species (ROS) levels in neuroblastoma cells 11 , male germ cells 12 , intestinal epithelial cells 13 , and kidney tubular cells 14 , causing mitochondrial dysfunction and changes in intracellular signaling pathways, inducing cell apoptosis and causing oxidative stress damages to the immune system, nervous system, reproductive system and digestive system 10,11,12,13,14

Future work should adopt longitudinal designs to assess therapeutic effects across temporal windows

Individuals with severe B12 deficiency benefit most from IV infusions because intravenous delivery raises serum levels faster than other supplementation routes