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Because IGF-I exerts anti-inflammatory actions and is important for peripheral glucose uptake, metabolic disturbances in these patients can, in part, be explained by the low IGF-I levels (83)

This hormonal cascade also leads to an increased heart rate, higher blood pressure, greater blood flow to the muscles, and heightened tension and stress sensitivity

Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, et al

Cardiovasc Intervent Radiol 32:13001303 Callstrom MR, Kurup AN (2009) Percutaneous ablation for bone and soft tissue metastases-why cryoablation

Many patients who respond well to B12 notice improved alertness and steadier energy