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[1] [4] When B12 is deficient, myelin production is impaired, leading to demyelination—the breakdown of this protective sheath—which results in abnormal nerve signalling perceived as pain, tingling, or numbness

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From that, he draws a broader conclusion: ACL reconstruction "hasn't been shown to offer any benefit over non-surgical care" for many patients, though he does acknowledge surgery is sometimes the right call depending on the athlete's level and individual circumstances