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Common additions include: B1 (Thiamine): Supports carbohydrate metabolism and energy production B2 (Riboflavin): Required for fat and protein metabolism B3 (Niacinamide): Supports over 400 enzyme reactions, including those involved in energy metabolism B5 (Dexpanthenol): Essential for the synthesis of coenzyme A, which is required for fatty acid metabolism B6 (Pyridoxine): Supports amino acid metabolism and neurotransmitter synthesis B12 (Methylcobalamin/Cyanocobalamin): Critical for energy production, red blood cell formation, and methylation reactions Why they matter: B vitamins are cofactors in virtually every metabolic process

Exceeding +2 SDS warrants dose reduction regardless of Child-Pugh class