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Other factors include: Underlying cause of deficiency : Pernicious anaemia, malabsorption disorders, or dietary insufficiency may affect treatment response Medication use : Metformin and proton pump inhibitors can reduce gastrointestinal B12 absorption (though this does not affect the efficacy of intramuscular injections) Individual variation : Differences in how efficiently your body utilises the injected vitamin Adherence to treatment schedule : Missing injections or delaying maintenance doses can slow recovery Discussing these factors with your healthcare provider helps set realistic expectations for your treatment journey

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Dysfunctional hypothalamic function can be seen in ME/CFS patients in the form of up-regulation of hypothalamic 5-hydroxytryptamine (5-HT) receptors (441) and abnormal arginine/vasopressin responses to deprivation tests and water loading (440)

[PubMed] [Google Scholar] 235.Rooke K.C

Kaya C, Higgs D, Burton A (2000) Plant growth, phosphorus nutrition, and acid phosphatase enzyme activity in three tomato cultivars grown hydroponically at different zinc concentrations