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There is mounting evidence that elevated plasma homocysteine (and therefore decreased serum methionine) contributes to congenital neural tube defects

DNA synthesis and cell metabolism Intracellular conversion of vitamin B 12 to two active coenzymes, in mitochondria and adenosylcobalamin in the cytoplasm, is necessary for the homeostasis of methylmalonic acid and homocysteine, respectively

Some people with the condition don't have any symptoms, at least at first

As we get older, this absorption problem compounds: the body's ability to absorb nutrients through digestion decreases progressively, and some adults become completely unable to absorb B12 orally regardless of dose