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However, recurrent bouts of such inflammation and the toxic milieu that ensues, are thought to produce cumulative damage to myelin, oligodendrocytes and neurons, leading to progressive degeneration, atrophy and increasing disability, exacerbated by failure of myelin repair

23 GBD 2019 Stroke Collaborators (2021)

Right now, most people cant get these compounds in a safe, controlled manner, so they get them however they can, says Husain

Testosterone can also alter insulin or oral diabetic medication requirements: it may improve insulin sensitivity or otherwise lower blood glucose, so diabetic patients on insulin or hypoglycemic drugs might need their dosages reduced to avoid hypoglycemia

Gastric Bypass Surgery: Procedures that remove or bypass parts of the stomach and small intestine dramatically reduce the body's ability to extract B12