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These drugs reduce ROS generation through multiple mechanisms: by enhancing mitochondrial biogenesis and fusion (via PGC-1), activating cAMP/PKA and PI3K/Akt pathways, increasing expression of antioxidant enzymes such as SOD2 and catalase, and restoring endothelial NO bioavailability [449,450]

Eligible studies included randomised controlled trials, cohort, and case-control studies assessing B12 supplementation efficacy via oral, sublingual, or IM administration routes

[DOI] [PubMed] [Google Scholar] Snapir A, Heinonen P, Tuomainen TP, Alhopuro P, Karvonen MK, Lakka TA, Nyyssnen K, Salonen R, Kauhanen J, Valkonen VP, et al