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Lipid droplet-derived monounsaturated fatty acids traffic via PLIN5 to allosterically activate SIRT1
That can actively cause vitamin B12 deficiency
Acute symptoms such as fatigue may improve within days, whilst neurological symptoms like paraesthesia typically require weeks to months of treatment
Further, a secondary analysis of a trial in women at high risk for or with existing cardiovascular disease reported that high-dose supplemental B-vitamins (1 mg/day of vitamin B 12 , 50 mg/day of vitamin B6, and 2.5 mg/day of folic acid) for 7.3 years had no effect on risk of non-vertebral fractures (122)
