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A few small studies and case reports show improved markers, such as sperm quality or ovarian reserve, but larger randomized trials are required to establish evidence

Some users find it harder to fall asleep or experience changes in sleep quality

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These risks must be carefully weighed against the anticipated therapeutic benefits to provide a balanced and realistic perspective for translational applications (Kochman et al., 2026)

Early parallel studies, such as the 2023 EMHPS asthenia study from Immanuel Kant Baltic Federal University, have already demonstrated that combining cellular antioxidants with Vitamin B6 significantly reduces rapid fatigability, resolves sleep disturbances, and improves mitochondrial endurance (measured by the 6-minute walk test) in post-viral patients

The use of the glucose-lowering drug metformin is causally related to lowered serum concentrations of vitamin B12 [40,41,42,43,44,45,46]