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Whilst this paper describes a statistically significant reduction in pain measured by the numeric rating scale (NRS) from baseline in both arms, there was no enhancement of outcome with the addition of B12 and ALA

Depending on how long youve been off the medication, they may recommend restarting at a lower dose and re-titrating upward to reduce the likelihood of gastrointestinal side effects

Lab testing should be used in conjunction with guidance from a qualified healthcare provider

3.2.2 Gut microbiota alterations in BD Biologically, people with BD, especially those who haven't started treatment, show noticeable changes in their gut microbiome

Clinically, I'd argue that's only meaningfully true at maximum doses, which most of my patients should not be on in the first place