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[74, 75] also warned that research on vitamin B supplementation gives contradictory results without scientific evidence for cognitive improvement

Environmental factors such as heavy metal toxicity [1012], sub-clinical viral infections [13] and gastro-intestinal pathology [14, 15], as well as endogenous toxins produced by metabolic processes [16], hormones (reviewed in [17]) and gastro-intestinal bacteria [18, 19] have also been suggested as playing a role in the aetiology of the disorder, although none of these have been thoroughly investigated

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Understanding these aspects allows everyone to make an informed decision about which route is appropriate for their situation