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10.3389/fnagi.2019.00333 157 KnopmanD

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This results in cell signaling through downstream kinases AMP-activated protein kinases (AMPK) (792), protein kinase Akt (791), and mitogen-activated protein kinase (MAPK)(791) which ultimately regulates angiogenesis (ubiquitin ligase Siah (Siah1/2) and hypoxia-inducible factor 1 (HIF1) (793)), insulin sensitivity (glucose transporter 4 (Glut4)(794)), re-vascularization (Rac1(795)), and vasodilation (COX(796), endothelial nitric oxide synthase (eNOS)(797,798))

Lab Findings: Vitamin D: 18 ng/mL (deficient) Vitamin B12: 240 pg/mL (low-normal) Ferritin: 28 ng/mL (suboptimal) Treatment Plan: We started her on a tailored vitamin D3 supplement, B12 injections once a week for 8 weeks, and a balanced nutrition plan rich in lean proteins and healthy fats