When B12 runs low, symptoms tend to creep in slowly enough to get blamed on something else: persistent fatigue, brain fog, low mood, weight gain or difficulty losing weight, weakness, tingling in the hands or feet, shortness of breath, and a weakened immune system
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These mechanisms may accelerate the pharmacokinetic changes in the affected drug and lead to clinically relevant DDIs, particularly in drugs with a narrow therapeutic window
Conversely, in uterine fibroids, it induces a pro-oxidative state characterized by elevated intracellular ROS levels, thereby promoting fibroblast apoptosis and reducing glycolysis and fibrosis
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