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Many patients with B12 deficiency, especially those with pernicious anemia, have difficulty clearing cyanide

In response, cities expanded sewer networks and installed municipal water filtration systems, treating sanitation as a public responsibility rather than a private household matter

Subsequently, this effect is reversed by the decreasing Nrf2 levels in the nucleus (nNrf2), leading to a decreased Keap1 level that is accompanied by a recovery of unbound Nrf2 because of a decreased sequestration in complexes with Keap1 (Fig 3C

This echoes a broader challenge in the supplement industry, where individual responses vary dramatically based on baseline nutritional status, diet quality, medication dosage, and other factors