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In essence, each component supports different steps of metabolic pathways, for example, energy generation from carbohydrates and fats requires B, B, B, and B in sequence

A differential for the myelopathy would include various metabolic, toxic, immunologic, and infectious disorders, such as copper deficiency myelopathy (possibly precipitated by zinc toxicity), folate deficiency myelopathy, vitamin E deficiency myelopathy, nitrous oxide toxicity, HIV-related vacuolar myelopathy, HTLV-1-associated myelopathy, neurosyphilis, and possibly Lyme disease

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Its effects on metabolic and appetite-signaling pathways continue to be an active area of cell-based research

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