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After reviewing literature and conducting a two-round Delphi survey with 42 experts, a consensus emerged that emphasizes prioritizing clinical symptoms in diagnosis, with serum B12 as a screening marker supported by methylmalonic acid or homocysteine levels for additional confirmation

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In particular, the heterogeneity of studies, publication bias or the quality of included studies should be fully considered when referring to meta-analysis (Niu C

Enhanced blood circulation and nutrient supply to active muscles contribute to better recovery

Then, at some point, due to increasing number of crystals or other inciting factor, the matches are struck and the inflammation begins

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