Ochratoxin A is a ubiquitous mold toxin (mycotoxin), and it is present in relatively low amounts in grains, nuts, legumes, teas, coffees, and root vegetables. Because it is also commonly found in water damaged buildings, and it is one of the most frequently recovered toxins in urine-based mycotoxin testing from Mosaic, Real Time Labs, and Vibrant America. It is linked to organ damage, neuroinflammation, and oxidative stress.

High serum B12 in chronic illness might reflect a deficiency caused by oxidative stress, deficiencies in B2, Glutathione, Molybdenum, Iodine, sulfur, or Selenium. Aberrant excess nitric oxide from nNOS (NOS1) and iNOS (NOS2) degrades B12 rendering it useless. Hydroxocobalamin inhibits nNOS (NOS1) and iNOS (NOS2). nNOS and iNOS are often upregulated from bacterial and viral infections, and a cascade of inflammation starting in the microbiome. Lowering oxidative stress with a diet rich in anti oxidants can be helpful too.