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Nausea affects approximately 32% of patients, but this typically occurs early in treatment and resolves within weeks

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Vitamin B1 and B6 are particularly active in the methionine cycle and citric acid cycle, integral processes in mitochondrial energy production

However, these warning signs represent serious underlying cellular dysfunction that can progress to irreversible complications including subacute combined degeneration , cognitive decline , and neural tube defects in developing pregnancies

Lebers hereditary optic neuropathy: B12 supplementation can worsen the conditionconsult a specialist (MedlinePlus)