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Those who reported no improvement in global well-being had a minimal change in vitamin B12 levels, no significant improvement in the physical functioning scale of the RAND-36, no significant increase in number of steps, and no significant improvement in the CIS20r fatigue scale

Polycythemia vera, a rare blood disorder, where careful medical oversight is appropriate

discovered elevated homocysteine concentrations in MS patients but reported no difference in B12 values across groups [128]

Regarding severe adverse events (Grade 3 and 4), only two side effectsanorexia and pleural effusionexhibited a significant difference, with the chemotherapy group experiencing more incidents