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The presence of peripheral sensory-motor symptoms or subacute combined degeneration of the spinal cord strongly suggests the presence of a B 12 deficiency instead of folate deficiency
The B12 deficiency itself getting worse, either because not enough unhealthy red blood cells have expired and been replaced by healthy ones (each one of them has a 90 day life-cycle), or because the B12 wasnt injected on a daily schedule
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Tirzepatide for MASH with fibrosis 15 mg produced a large majority disease-resolution rate versus a small placebo rate: Loomba NEJM 2024 (SYNERGY-NASH)
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