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The methodological quality of the included studies, as assessed through the Jadad and NewcastleOttawa scales, varied from moderate to high, while the GRADE assessment indicated moderate certainty of evidence for serum vitamin B12 increase and low certainty for homocysteine reduction

If you have ongoing problems with pain, you may want to see a physiatrist (specialist in rehabilitation) or a pain specialist to ensure that you have access to the widest range of treatment options

therefore, patients older than 50 years and vegans or strict vegetarians should consume foods fortified with vitamin B 12 or take vitamin B 12 supplements

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In the future, novel treatment approaches will need to be directed towards increasing the bioavailability of plant chemicals by ultra-modern delivery mechanisms like nanoformulations, phytosomes, and controlled-release technologies