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In turn, this may contribute to the development of depression by increasing oxidative stress, DNA damage, and cell death in the body ( A 2020 study with 132 children and teens, 89 with and 43 without depression, found that the participants with depression had lower B12 levels and higher levels of homocysteine compared with those without depression ( In addition to depressive symptoms, low or deficient B12 levels may lead to other mental conditions, including psychosis and mood disorders ( Because a deficiency in B12 negatively impacts the central nervous system, people with low or deficient B12 levels may feel foggy-headed and have difficulty concentrating and completing tasks ( Fortunately, studies show that mental impairment related to low B12 levels can improve with B12 treatment

It is unclear, however, whether high doses of ESA are inherently toxic or whether hyporesponsiveness is a marker of adverse outcomes related to comorbidities

Most useful as part of a structured recovery plan after injury, surgery, or in patients with persistent tendinopathy

visceral) also respond differently

Johansson ME, Sjovall H, Hansson GC