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The phase 1b trial characterised them: mostly ecchymosis (bruising, in 79% of those affected) and redness (32%), all mild, and, critically, not dose-dependent

High-Risk Populations for B12 Deficiency Some groups are more likely to have vitamin B12 deficiency

Hormonal alterations Since stress has been described as a potential trigger for ME/CFS (422) and cause of symptom flare-ups (423, 424), it is likely that the HPA axis- the neurobiological stress system- may be implicated in ME/CFS (53, 425, 426), as well as abnormalities in growth hormone (GH) secretion and dysfunctional adrenergic metabolism (255)

Most studies consist of small human pilot studies conducted in the 1980s and a large body of animal preclinical data arising after the fact