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J Biol Chem 276:4808392, PMID: 11675377 Pandey KB, Rizvi SI (2010) Markers of oxidative stress in erythrocytes and plasma during aging in humans

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By breaking down intracellular components, autophagy sustains bioenergetic balance and promotes cell survival until favorable conditions are restored ( Autophagy is a highly conserved catabolic process involving four key steps: initiation, autophagosome formation and maturation, fusion with lysosomes, and degradation of autophagic cargo

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Additional injections of 100 mcg monthly may be needed depending on level of symptom improvement and cause of vitamin B12 deficiency

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