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Patients should be vigilant for symptoms such as a lump or swelling in the neck, hoarseness, or difficulty swallowing and report these promptly to their healthcare provider

57 Positive effects of B12 on homocysteine levels have also been observed in other patient populations, including healthy adults, 46 vegetarian women, 58 generally healthy women, 59 older adults with elevated MMA and homocysteine, 37 and patients with type 2 diabetes mellitus

One study in people over the age of 60 linked high blood levels of folate or UMFA to mental decline in those with low vitamin B12 levels

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