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PMCID: PMC11042726

8,9 Manifestations Vitamin B 12 deficiency affects multiple systems, and sequelae vary in severity from mild fatigue to severe neurologic impairment 1,2,6,10 (Table 2 4,10 )

Peripheral neuropathy manifests as numbness, tingling, and limb weakness, predominantly affecting the lower extremities (Winstock and Ferris, 2020)

Lee et al.'s RCT validated these mechanisms in real patients using topical application

The Irving-Williams series denotes the stability of divalent metalligand complexes, typically following the sequence: Mn 2+ 1000-fold over the target element, significantly hinder the purification of critical elements using protein-based methods