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However, oral B12 supplementation or dietary sources remain first-line for mild insufficiency

The role of homocysteine in increasing the risk of hemolysis in vitamin B12 and folate deficiency has been demonstrated in vitro .[7] We postulate that the high homocysteine levels in our case may have played a role in ensuing hemolysis in addition to intramedullary destruction of RBCs

peripheral vascular thrombosis Hematological : Polycythemia vera (a rare type of blood cancer) Gastrointestinal : Mild, transient diarrhea Dermatological : Itching

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