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First, hyperhomocysteinemia detected only in the fasting state (approximately 23% of patients), which might mainly result from an inhibition of the homocysteine remethylation pathway (folate, cobalamin, or functional methionine synthase deficiencies or thermolabile MTHFR mutation), and which increases the cardiovascular risk 1.6-fold

B12 works with other B vitamins in many biochemical cycles, so its important to understand the whole picture and look at a variety of nutrients, she says

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In addition to these points, it is worth noting that carpal tunnel injections should be considered a temporary solution rather than a long-term fix

As we age, stomach acid production can decline (atrophic gastritis), which makes it harder to extract B12 from food or pills