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Vitamin B12 is obtained through food sources such as beef, liver, chicken, fish (trout, salmon, tuna, clams), fortified breakfast cereals, lowfat dairy products, and eggs

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In SPMS, characterized by steady deterioration without acute attacks, treatment strategies often involve continuing or altering DMT used during the earlier RRMS phase, such as interferon beta, or considering immune-modulating agents, such as methotrexate, cyclophosphamide, or glucocorticoid pulses [142, 143]

Vitamin B12 : Boosts energy metabolism and prevents fatigue, allowing individuals to maintain an active lifestyle despite caloric restriction