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Any significant changes in symptoms such as increased fatigue, yellowing of eyes or skin, abdominal pain, or unexplained bruising should prompt immediate medical consultation rather than self-treatment with supplements

171 Trials in aging men with erectile dysfunction have found treatment with tribulus extract, at a dose of 250 mg three times daily for three months, can increase testosterone levels and improve erectile function without worsening lower urinary tract symptoms

Therefore, clinicians should consider ruling out vitamin B 12 deficiency before initiating folic acid therapy

If you are experiencing symptoms or managing a chronic condition, a personalized Root Cause Analysis with a functional nutritionist is the right next step