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Analysis of histological specimens disclosed that 13 patients (45%) had porto-sinusoidal vascular liver disease (PSVD) typically associated with nodular regenerative hyperplasia, defined by abnormal hepatocyte plates, nodular transformation, and markedly dilated portal and centro-lobular veins [27]

You might wonder how a pill works if you lack intrinsic factor: at very high oral doses, a small amount of B12 can be absorbed directly through the gut wall via passive diffusion, bypassing the need for intrinsic factor entirely [1] [3]

This isnt medication failure

As reported, ROS generates hydrogen peroxide, which is a harmful molecule that can be scavenged by the glutathione peroxidase through GSH, it is found in the cytosol and the mitochondria, and by the catalase which is present in the peroxisomes

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It could be raw veggies, a salad, fried or greasy foods