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Tetramethylpyrazine (TMP), an active component in both CHF and the medicinal herbs Ligusticum wallichii (Chuanxiong) , has the potential to prevent AKI via a variety of processes, including ameliorating oxidative stress damage, suppressing inflammatory responses, deterring apoptotic cell death of intrinsic renal cells, and modulating autophagy (Gong, 2018

Specific plasma amino acid ratios, such as Ala/Leu, Ala/Lys, Pro/Leu, (Ala+Pro)/Leu, and (Ala+Pro)/(Leu+Lys) and their combinations, are highly sensitive (90% or greater, depending the specific ratio or combination ratios used) but only 75% to 85% specific for identifying individuals with pyruvate dehydrogenase complex deficiency (07

This information is invaluable for your healthcare provider in determining whether symptoms are genuinely related to B12 supplementation or reflect an independent condition requiring separate investigation