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As cells age, mitochondria can become less efficient, leading to a decline in overall cellular function

The vitamin is also essential for DNA synthesis and red blood cell formation, meaning deficiency can have wide-ranging effects beyond the nervous system, including fatigue and cognitive difficulties

This is the most frequent effect and is the body's normal response to a small puncture

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The neurological aspects of the disease are thought to arise from the accumulation of methylmalonyl- CoA due to the requirement of B 12 as a cofactor to the enzyme methylmalonyl-CoA mutase