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Focusing on the nervous system, several studies highlight how metabolic alterations due to VitB12 deficiency can trigger molecular/cellular changes, such as the accumulation of oxidative stress, epigenetic modifications, modulation of gene expression or protein content, or alterations in lysosomal activity

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They are not a replacement for physical therapy, and recovery still depends on progressive loading, exercise, sleep, nutrition, and consistent rehab, with peptides considered only as a cautious adjunct under professional guidance