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The first signs of B12 deficiency include persistent fatigue, weakness, lightheadedness, pale skin, tingling or numbness in the hands and feet, difficulty concentrating, and mood changes like irritability or mild depression

Combined with morphological observations, these transcriptional data allow us to propose a model for parasitic responses to treatment: Following DHA exposure, parasites at early stages upregulate protein synthesis to repair DHA-induced damagea compensatory mechanism that ultimately fails, as DHA causes irreversible, lethal injury

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Several pathogenic mechanisms have been proposed