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AskarpourMHadiASymondsMEMiraghajaniMOmidSSheikhiAet al

[2] Patients should contact their GP if they experience: Side effects from B12 injections (though these are rare and usually mild) Difficulty attending scheduled injection appointments, as missed doses may lead to symptom recurrence New symptoms developing during treatment Concerns about treatment effectiveness or duration Changes in other medications that might affect B12 absorption Suspected adverse reactions to B12 treatment can be reported through the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk)

Transport of pyruvate across the inner mitochondrial membrane requires the mitochondrial pyruvate carrier (MPC) complex

Note one recurring literature trap: the dimer (CKPV) is a chemically different molecule with its own clinical record, and results attributed to it do not transfer to bare KPV, on which no human trials exist

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