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Acetyl-L-carnitine, for instance, crosses the blood-brain barrier more readily and has been studied for neurological applications

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N Engl J Med (2005) 353(3):24954.10.1056/NEJMoa043690 19 GoldfineABMunECDevineEBernierRBaz-HechtMJonesDBet alPatients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal

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Varicocele repair also can increase testosterone levels, although rigorous data supporting its use remain lacking

If symptoms do not improve despite adequate B12 replacement, further investigation for other causes of nerve pain will be necessary