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Aside from the pain and stiffness another big symptom for me is what I've come to think of as 'missing words'

According to the American Medical Association, CPT code 90471 means &

AOD 9604, 5mg A synthetic peptide fragment derived from the C-terminal region of human growth hormone (hGH), commonly utilized in laboratory research involving metabolic pathways, adipose tissue biology, energy regulation, and peptide-mediated cellular signaling

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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