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Mean and standard error was calculated for all quantitative experiments

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doi: 10.1016/j.atherosclerosis.2009.06.019 218 NaruszewiczMJohanssonM-LZapolska-DownarDBukowskaH

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Its pathophysiology involves multiple interconnected mechanisms, including monoaminergic neurotransmitter depletion, impaired neurotrophic signaling, neuroinflammation accompanied by hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and glutamate-induced excitotoxicity (Medeir et al., 2020)

These metabolites accumulate when b12 function becomes inadequate, sometimes before serum b12 drops below normal range