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Numbness or Tingling in Extremities: Some individuals may experience a sensation of pins and needles in their hands and feet

Each stage of respiration, from glycolysis in the cytoplasm to the citric acid cycle and oxidative phosphorylation in mitochondria, depends on NAD+/NADH to carry reducing equivalents, thereby driving the production of cellular energy

It's usually treated with B12 injections or high-dose oral supplements, dietary advice, and, in some cases, proton pump inhibitors to reduce stomach acid levels