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At this point, permanent damage can take place, as the nervous system is exceptionally vulnerable to a lack of B12

[DOI] [PubMed] [Google Scholar] 23.Falcone JA, Salameh TS, Yi S, Cordy BJ, Mortell WG, Kabanov AV, Banks WA

By inhibiting NNMTs consumption of SAM, 5-Amino-1MQ may affect the methylation status of various cellular targets

It doesn't require anything more exotic than the basic fact that this population is routinely left out of the research that would answer the question

Between 25% and 45% of patients report mild to moderate nausea, and vomiting occurs less frequently but remains a real concern for some individuals beginning therapy