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The epidural space surrounds your spinal cord like a sleeve and contains fat, spinal nerves, blood vessels and connective tissue

and Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences (CI2021A04607)

Patients who are pregnant, breastfeeding, have unstable psychiatric symptoms, bipolar disorder, psychosis, significant medical conditions, autoimmune concerns, cardiovascular concerns, substance use concerns, or complex medication regimens should be especially cautious

This is due to damage to the gastrointestinal system that limits their B12 absorption and genetic polymorphisms that reduce their B12 utilization