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After reviewing literature and conducting a two-round Delphi survey with 42 experts, a consensus emerged that emphasizes prioritizing clinical symptoms in diagnosis, with serum B12 as a screening marker supported by methylmalonic acid or homocysteine levels for additional confirmation

Additionally, there is some evidence to support the use of pramipexole in patients with TRD in unipolar and bipolar depression

The key, as with other autoimmune diseases, is to find the root cause of the root cause of the problem

Inflammaging can be stimulated by a range of factors, including disordered gut microbiota, which can create a pro-inflammatory environment in the digestive tract and promote systemic inflammation

At that point the remaining free radicals and toxins steal electrons from the cells organelles, membranes, and DNA, causing substantial damage and generating even more free radicals