Finally, vitamin B12 is crucial for the biochemistry of the nervous system, participating in DNA synthesis, methionine synthesis, methylation reactions, myelin synthesis, and neurotransmitter production (70, 73, 77)
This includes people with: Pernicious anaemia (autoimmune destruction of intrinsic factor-producing cells), typically requiring lifelong IM injections Crohn's disease or surgical resection affecting the terminal ileum Coeliac disease causing malabsorption (may improve with gluten-free diet) Chronic pancreatitis reducing enzyme availability needed for B12 release Vegans and strict vegetarians need reliable B12 sources through fortified foods or supplements, as plant-based diets contain negligible amounts of active B12
150 , 151 , 152 , 153 It is important to keep in mind that individuals metabolic and neurobiological responses to diet vary, and that a one size fits all approach to diet may not be effective in reducing risk of cognitive decline and dementia
It can also help break weight plateaus caused by metabolic resistance
Comorbidities like type 2 diabetes and metabolic syndrome a cluster of metabolic disorders that includes obesity, dyslipidemia, hypertension, and insulin resistance, leading to chronic systemic inflammation
Providers often recognize the presentation but don't name the syndrome, defaulting to D50.9 when D50.1 is the more specific and more accurate code