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For those who struggle to reach an ideal B12 level via diet alone, you need to supplement

But if the power plant (brain) and wires (nerves) are damaged, voluntary effort alone may never restore full function

Among the proposed mechanisms, dysregulation of lipid metabolism appears to be a leading factor

PLoS One 19 (8), e0307735

Vitamin B12 injection should be administered only under the recommendation and guidance of a medical professional and they should be aware of complete medical history including any conditions such as hypokalemia, polycythemia vera, gout, Lebers disease, iron and/or folic acid deficiency

While supplementation with Clostridium has shown therapeutic effects on vasculitis animal models, its efficacy in patients remains to be confirmed