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NAD+ is crucial for mitochondrial energy production, it serves as the cofactor for the Krebs cycle and oxidative phosphorylation, the cells ways of producing ATP

While its true that receptor density can change due to various factors, its an oversimplification to suggest that this change is the direct cause of increased pain or sensations in B12-treated individuals

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Low stomach acid caused by hypothyroidism reduces your ability to absorb B12 from food, creating a vicious cycle where low thyroid worsens B12 deficiency and B12 deficiency worsens thyroid symptoms