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Osteoarthritis affects joints leading to lower concentration of hyaluronic acid in their joint fluid than normal healthy joints, and therefore less protection against joint friction and impact accelerating the joint degeneration process

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The resultant oxidative stress adversely impacts cochlear homocysteine metabolism, suggesting a potential link between Vitamin B12 deficiency and demyelination of neurons in the cochlear nerve, axonal degeneration, and neuronal death

How to prevent further deficiency

Vitamin B12 deficiency is easily treated by regular injections of vitamin B12

Common restrictions include step therapy, where you must try cheaper medications first, or meet clinical thresholds like hemoglobin A1C levels above a certain point