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Requirements of vitamin B12 in excess of normal (due to pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, malignancy, hepatic and renal disease) can usually be met with oral supplementation

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Alterations in NO-mediated endothelium-dependent vasodilation results in widespread vasoconstriction and coagulation abnormalities and is considered to be an early step in the development of atherosclerosis

When this system becomes disrupted, patients may experience symptoms such as abdominal pain, bloating, diarrhea, constipation, urgency, food sensitivity patterns, fatigue, or systemic inflammatory complaints

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