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A paired test showed that in Group A, patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analogue scale (VAS) after Vitamin B12 therapy

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By blocking this enzyme, the molecule preserves the cellular NAD+ pool, supports sirtuin activation, and stimulates energy expenditure through improved mitochondrial function

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Earlier studies suggested that PA was restricted to Northern Europeans, but subsequent studies indicate that PA affects virtually all ethnic groups.37 Pernicious anaemia was considered a classical cause of vitamin B 12 deficiency before food-cobalamin malabsorption was described, and accounted for 15% to 25% of vitamin B 12 deficiency in the elderly in studies.9 In a local study on 296 Chinese patients, definite PA was diagnosed in 61% of patients having megaloblastic anaemia with vitamin B 12 or folate deficiency.38 Pernicious anaemia is characterised by destruction of gastric mucosa, especially fundal mucosa, primarily by a cell-mediated mechanism.39 There is progressive destruction and eventual loss of intrinsic factor producing gastric parietal cells