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Male Fertility L-carnitine has been linked to improvements in sperm quality and motility, suggesting it may play a role in treating male infertility
However, when liver damage progresses to non-alcoholic steatohepatitis (NASH) or cirrhosis, injured liver cells may release stored B12 into the bloodstream, causing elevated serum levels
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Its overactivation disrupts nicotinamide metabolism, reduces NAD+ levels, promotes hepatic lipid accumulation and lipotoxicity, and represents an important therapeutic target for hepatic metabolic disorders
The British Society for Haematology emphasises that treatment should not be delayed whilst awaiting confirmatory test results if clinical suspicion of B12 deficiency is high, particularly when neurological symptoms are present
