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549 Impaired oxidation of NADH, a function of respiratory complex I, increases NADH levels, driving the equilibrium toward lactate accumulation, which differs from the proportional increase in lactate and pyruvate seen in pyruvate dehydrogenase deficiency

You may notice subtle changes in 2-4 weeks

Pale Skin and Shortness of Breath People with a B12 deficiency may develop pale skin due to a decrease in red blood cell production, which can also lead to feelings of shortness of breath

Over the study period, urinary excretion of aluminum increased without affecting urinary excretion of the essential metals iron and copper