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The difference with the Toroidal-pore model is that the AMPs working through the Aggregate model have no specific orientation and there is usually only one AMP located in the center of the aggregate

Patients with gastrointestinal disorders such as Crohns disease, celiac disease, or those who have undergone gastrointestinal surgeries (including gastric bypass) often experience impaired B12 absorption

Furthermore, decreased NAD+ levels, potentially a consequence of reduced kynurenine, may contribute to fatigue by impairing energy production, and disrupting the coordination of circadian rhythms necessary for effective sleep (reviewed in Dehhaghi et al., 2022)

Meaningful assessment requires six to twelve months minimum