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PMID: 33051718

Withhold Pemetrexed Injection in patients with a creatinine clearance of less than 45 mL/minute [see Dosage and Administration (2.3)]

Furthermore, the impact of vitamin B 12 deficiency on peripheral neuropathy in diabetic patients has been a subject of investigation, with studies demonstrating an association between vitamin B 12 deficiency and peripheral neuropathy in individuals with type 2 diabetes mellitus [14, 18, 19, 23]

Without sufficient B12, this sheath can weaken, which may explain symptoms such as tingling, numbness, memory issues, or brain fog. From an energy standpoint, B12 supports the methylation cycle , a chemical pathway involved in energy metabolism and detoxification