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To avoid metHb accumulation, reducing pathways mediated by cytochrome b5 or flavin coupled with NADH- or NADPH-dependent metHb reductases (MHbR), respectively, keep the level of metHb in erythrocytes at less than 1% of the total Hb under normal conditions (48)

Following the standard titration schedule significantly reduces severity

Thanks to the Vegan Society for allowing us to link to their website: Devalia V et al (2014) Guidelines for the diagnosis and treatment of cobalamin and folate disorders [Accessed 29.11.19] Linnebank et al (2011) Antiepileptic drugs interact with folate and vitamin B12 serum levels [Accessed 22.10.19] Sukumar and Saravanan (2019) Investigating Vitamin B12 deficiency [Accessed 29.11.19]