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Nausea and vomiting are likely to occur, and the gag reflex will be impaired, which could cause choking or aspirating on vomit

Only people with vitamin B12 deficiencies should take oral B12 supplements (thats about 6 percent of the US population under age 60)

When a person with Down syndrome has vitamin B12 and/or folate deficiency, the increase in the homocysteine level may not be great enough to overcome this starting low value of homocysteine

No study has tested these three together in animals or humans, so the synergy is reasoned from mechanism, not measured

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However, these painful episodes can extend to two minutes or longer as the condition progresses