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Certain populations face higher deficiency risk: vegetarians and vegans (B12 is primarily found in animal products), adults over 50 (decreased stomach acid reduces B12 absorption), individuals with digestive disorders like Crohn's disease or celiac disease, and those taking medications like metformin or proton pump inhibitors
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Risk factors include older age, baseline low blood pressure, concurrent blood pressure medications, rapid dose escalation, and insufficient fluid intake
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Concurrently, L-lactate induces HIF-1 and ROS accumulation, disrupts the G2/M checkpoint, and impairs DDR mechanisms
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