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It activates the Akt survival pathway, recruits stem cells to injury sites, promotes endothelial cell differentiation for angiogenesis, and upregulates matrix metalloproteinases for tissue remodeling

[44] [41] Vitamin B 12 is not one of the supplements recommended by the World Health Organization for healthy women who are pregnant, [14] however, vitamin B 12 is often suggested during pregnancy in a multivitamin along with folic acid [45] [46] especially for pregnant mothers who follow a vegetarian or vegan diet

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For patients whose symptoms significantly impact quality of life, healthcare providers may consider evidence-based pharmacologic options such as certain SSRIs/SNRIs, gabapentin, oxybutynin, or fezolinetant (FDA-approved for moderate to severe vasomotor symptoms)