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Ask specific screening questions about pregnancy, lactation, and chronic conditions (pernicious anaemia, cardiac disease, hypertension) that may interact with parenteral B-12 therapy

In one nonhuman trial, researchers studied the effect of asparagus on high blood pressure

Experimental work indicates that statins disturb mitochondrial complexes, although this sits mainly in mechanistic studies rather than patient-level trial In clinic I treat these hypotheses as prompts to focus on whole-mitochondrial support sleep, nutrient-dense diet, physical activity matched to capacity, and careful review of polypharmacy rather than chasing every possible supplement

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