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In the primary healthcare setting, the most commonly seen causes of vitamin B12 deficiency are related to abnormalities of digestion (atrophic gastritis, achlorhydria or the consequences of gastrectomy) or absorption (autoimmune pernicious anaemia, chronic pancreatitis, Crohns disease, the effect of medications that alter the mucosa of the ileum, or the consequences of surgical resection), and, to a lesser extent, a lack of exogenous supply

In contrast, B12 injections offer a much more direct and reliable solution

Excess serotonin chemicals in the peripheral and central nervous system can cause symptoms that can include agitation, fever, hallucinations, irregular heartbeat, muscle stiffness and restlessness

Similarly, EVs originating from Candida albicans exacerbate host damage by reducing ROS production by activating arginine and NO metabolic pathways to decrease bacterial death [193]