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The symptoms can be subtle initially and may overlap with manifestations of liver disease itself, making recognition challenging

The most common causes include B12 supplementation (particularly injections), liver disease releasing stored B12, haematological disorders increasing B12-binding proteins, and chronic kidney disease reducing B12 excretion

Though most of that work is focused on males, a few peptides have been shown to affect sperm parameters like motility and capacitation, highlighting that peptides can act on reproductive cells and their environment

K., Kulik, V., & Goldstein, A

For these cells to do their jobs, they need to move to the location of injury