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High-dose oral therapy (10002000 micrograms daily) can be effective even in pernicious anaemia, as approximately 1% of B12 is absorbed through passive diffusion independent of intrinsic factor
Higher NAD+ activates the sirtuin family of NAD+-dependent deacetylases, particularly SIRT1, which deacetylates PGC-1alpha (promoting mitochondrial biogenesis), FOXO transcription factors (enhancing stress resistance), and NF-kappaB (reducing inflammation)
In MC4R loss-of-function carriers, appetite suppression in response to increased circulating free fatty acids (a downstream product of lipolysis) may be attenuated
Indicators pointing toward inherited neuropathy include a family history of similar symptoms, early onset of neuropathic complaints, or patterns of symptom progression that do not align with common causes such as diabetes or injury
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