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Surg Obes Relat Dis

Primary Health Benefits

At the origin of these divergences, several possible factors may be hypothesized, such as non-homogeneous populations selection, temporal discrepancies between competitive risk factors and influence of common complication including inflammation and protein-energy wasting (PEW) that could influence circulating homocysteine and that are associated with poorer outcomes [9]

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Response to treatment varies considerably: Paraesthesia and early sensory symptoms often improve within weeks Cognitive and mood symptoms may take several months to resolve Established spinal cord damage (subacute combined degeneration) may show incomplete recovery, particularly if treatment was delayed Gait disturbances and proprioceptive loss may persist despite adequate treatment Monitoring during treatment should include clinical review of symptom progression and full blood count

Eligible studies included randomised controlled trials, cohort, and case-control studies assessing B12 supplementation efficacy via oral, sublingual, or IM administration routes