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can glutathione affect menstrual cycle Variability of during the cycle—due to estrogen effects on hepatocytes? Glutathione: Master Antioxidant, Reducing Oxidative –

Introduction Overview vitamin B12 (cobalamin) is a water-soluble vitamin that is involved in the formation of hematopoietic cells and maintainance of myelin integrity vitamin B12 deficiency results in a megaloblastic anemia reversible dementia subacute combined degeneration Etiology decreased oral intake strict vegan diet breastfeeding in a vitamin B12 deficiency mother decreased animal product intake decreased absorption gastrointestinal surgeries illness medications autoimmune disease Pathophysiology absorption protein-bound vitamin B12 is released from protein by pepsin R-binder binds to vitamin B12 to prevent its degradation by gastric acid proteases in the duodenum separate R-binder and vitamin B12, allowing vitamin B12 to bind to intrinsic factor intrinsic factor bound to vitamin B12 is absorbed in the terminal ileum DNA synthesis vitamin B12 serves as a coenzyme for methionine synthase to produce myelin stabilization methionine is converted to S-adenosylmethionine vitamin B12 serves as a coenzyme for methylmalonyl-CoA mutase to convert methylmalonyl-CoA (produced from methylmalonic acid) to succinyl-CoA vitamin B12 deficiency impaired DNA synthesis significantly affects rapidly dividing cells (e.g., hematopoietic precursor cells) and leads to impair neuronal function Prognosis atrophic gastritis increases risk of gastric cancer Presentation Symptoms anemia fatigue dyspnea gastrointestinal glossitis neurologic cognitive decline Physical examination subacute combined degeneration lateral corticospinal tracts dorsal columns spinocerebellar tracts Labs macrocytic and megaloblastic anemia decreased serum B12 level reticulocytopenia ↑ serum methylmalonic acid and homocysteine levels anti-intrinsic factor and parietal antibodies seen in pernicious anemia Peripheral blood and marrow smear show hypersegmented neutrophils and megalocytes Differential Folate anemia differentiating factors no neurological manifestations methylmalonic acid levels are not elevated Treatment Medical intramuscular vitamin B12 indication Complications Irreversible neurological damage if untreated Create a free account or log in to see the cards.

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Importantly, the group that took the placebo was observed to have a significant increase in MDA levels in RBCs ( Figure 4E )