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Macrocytic anemia occurs when your body doesnt have enough normal red blood cells, and can cause symptoms including muscle weakness and paresthesias (paresthesias is the technical term for the pins and needles feeling on your skin)

Conversely, another possibility is that a lower C4B copy number might protect the stability of the host microbiome to some extent by reducing the excessive clearance of beneficial microbes mediated by C4B

For the broader picture, our NAD and peptides explainer covers why the two get confused

"Acetylcysteine for prevention of renal outcomes in patients undergoing coronary and peripheral vascular angiography." Circulation