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The consequences of reactive astrogliosis and microglial activation following SARS-CoV-2 infection can initiate a cascade of aberrant signalling events, potentially leading to excitotoxicity which represents a pathological process with deleterious consequences [15, 35]

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Key Takeaways: • Initial symptoms often include numbness, tingling, balance difficulties, and cognitive changes that can progress to severe neurological damage if untreated • Risk factors particularly relevant to Arizona adults include age over 65, vegetarian/vegan diets, certain medications like metformin and proton pump inhibitors, and gastrointestinal conditions • Diagnosis requires specific blood tests including serum B12, and when borderline, methylmalonic acid (MMA) and homocysteine levels provide more accurate assessment • Treatment options range from oral supplements to intramuscular injections and IV therapy, with effectiveness depending on the underlying cause and severity • Local resources in Gilbert include affordable testing facilities (as low as $12.34) and specialized providers including mobile IV therapy services Our comprehensive analysis reveals that while B12 deficiency poses significant health risks, Arizona residents have access to numerous diagnostic and treatment resources