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This not only drastically reduces the amount of ATP available for physical and cognitive tasks but also physically destabilizes the nervous system, leading to profound fatigue and neurological impairment

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So two years out it does seem like there's probably a chronic neuropathy that is not in that two-thirds of patients who just improve or go away

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Intrinsic Factor and B12 Absorption: Vitamin B12 is a very large molecule compared to other vitamins and requires an enzyme called intrinsic factor to metabolize effectively