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The most meaningful improvements come when treatment addresses root causes oxidative stress, nutrition, liver health, and lifestyle rather than surface symptoms alone

Kidney Dysfunction: While the kidneys do not directly excrete vitamin B12 efficiently, impaired renal function may lead to elevated serum B12 levels by reducing the clearance of B12-binding proteins or altering their metabolism, thereby contributing to B12 accumulation 8

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Proc Natl Acad Sci U S A (2005) 102:139984003.10.1073/pnas.0504398102 27 TakeuchiOAkiraS