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doi: 10.1007/s12020-021-02902-y 57 RubinsteinTJ

It is linked to the brains adjustment during abstinence

Several key pathways including Notch, phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), transforming growth factor- (TGF-), nuclear factor kappa (NF-B), bone morphogenetic protein (BMP), N-methyl-D-aspartic acid receptor (NMDAR)-Ca 2+ -Activin A, hippo-yes-associated protein (YAP), toll-like receptor 4/toll-interleukine-1 receptor domain-containing adapter-inducing interferon- (TLR4/TRIF) and hepatocyte growth factor/mesenchymal-epithelial transition factor (HGF/c-Met), and Wnt, have emerged as crucial players in this context

Oral and sublingual B12 supplements are readily available, but the general consensus is that intramuscular injections of B12 are the most effective and efficient means of delivery