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Mitochondrial dysfunction and apoptotic pathways Mitochondria-rich hair cells are particularly vulnerable to toxic insults

Mechanism involves NO system modulation (homeostatic regulationupregulating when deficient, moderating when excessive), VEGF/VEGFR2 upregulation for angiogenesis, FAK-paxillin pathway activation for cell migration (40% increase per Chang et al.), and EGR-1 transcription factor upregulation for growth factor sensitivity

have been advised by a healthcare professional to receive vitamin B12 replacement

There are scattered reports of hormonal and mood effects, though the research here is limited