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The chronic use of any of these medications has the potential to cause complications related to vitamin B12 deficiency, which includes impaired DNA synthesis, impaired cell division, hematopoiesis, hyperhomocysteinemia, and metabolism of odd-chain fatty acids that is necessary in preventing demyelination of nerves

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3 As we age, levels decline, which may contribute to fatigue, brain fog, and slower recovery

These perturbations lead to the release of mtDAMPs, rewire immune cell metabolism toward pro-inflammatory or immunosuppressive phenotypes, and impair the bioenergetic capacity needed for effective host defense and tissue repair ( Figure 2 )

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