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Example 2: The patient who cannot tolerate appetite suppression Another patient tries an incretin based medication and stops after a few weeks because the nausea is too disruptive

Conclusion This case underscores the diagnostic complexity in distinguishing true TMA from its mimics, particularly PTMA secondary to vitamin B12 deficiency

The most useful investigation is an MRI scan of the brain with and without contrast, which is used to rule out other potential causes of pain if the diagnosis is not clear cut or if red flags are present

Many individuals report feeling more energized and alert with regular B12/MIC use

investigation into the online supplements market has uncovered unscrupulous sellers listing injectable vitamin supplements on Etsy, and throwing in risky extras too