Many factors can stress the kidneys, such as heavy metals, infections, detox programs, and mold (mycotoxins). Low nitric oxide levels can contribute to kidney stress. Resveratrol is known for its heart-protective benefits, and this is why red wine, in moderation, is often linked to heart health. Reducing caffeine intake is also important, as it can inhibit nitric oxide production and put extra stress on the kidneys.

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.