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Changes in hormones

Endocr Rev 39(5):760802 Zhang H et al (2021) PPARalpha agonist relieves spinal cord injury in rats by activating Nrf2/HO-1 via the Raf-1/MEK/ERK pathway

Common signs include: Fatigue and weakness Neurological changes, such as numbness or tingling in the hands and feet Megaloblastic anemia, characterized by large, abnormal red blood cells Cognitive difficulties, including memory loss and confusion Early detection and treatment of B12 deficiency can make a big difference

Proc Natl Acad Sci 108:84858490 Rey E, Hernndez-Diz FJ, Abreu P et al (2001) Dopamine induces intracellular Ca 2+ signals mediated by alpha1B-adrenoceptors in rat pineal cells

Some patients might move from, say, weekly injections to monthly injections as maintenance, then eventually to none if possible

& Dolegowska, B