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Conversely, medications like metformin, H2 blockers, and proton pump inhibitors can reduce the absorption of Vitamin B12

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Metabolic B12 deficiency is prevalent, impacting 10%-40% of the population

Additionally, NO and superoxide can combine to generate peroxynitrite, which possesses higher cellular toxicity potential and worsens the consequences of oxidation [337]

Radiotherapy has been used for many years, but current evidence demonstrates a non-inferiority of chemotherapy with less impact on fertility, hypogonadism, and onset of second malignancies [332,333,334]