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Elevated Hcy leads to an increase in the generation of mitochondrial ROS, resulting in oxidative damage at the cellular and molecular levels, and suppression of antioxidant enzyme systems (Kaplan et al., 2020)

In a randomized, placebo-controlled intervention study with more than 900 older participants experiencing psychological distress, daily supplementation with folic acid (400 g) and vitamin B 12 (100 g) for two years did not reduce the occurrence of symptoms of depression despite significantly improving blood folate, vitamin B 12 , and homocysteine levels compared to placebo (109)

PET scans demonstrate improved cerebral glucose utilization within 72 hours post-injection, explaining the rapid cognitive benefits reported by patients

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Vegetarians and vegans especially need to be careful and consider supplements, as most common vitamin B12 food sources do not fit with these diets