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Vitamin B 12 (cobalamin) deficiency is a common cause of macrocytic anemia and has been implicated in a spectrum of neuropsychiatric disorders.The role of B 12 deficiency in hyperhomocysteinemia and the promotion of atherosclerosis is only now being explored.itamin B 12 deficiency, therefore, can lead to increased levels of serum methylmalonic acid. In the second reaction, homocysteine is converted to methionine by using vitamin B 12 and folic acid as cofactors. In this reaction, a deficiency of vitamin B 12 or folic acid may lead to increased homocysteine levels.
Pernicious Anemia. Macrocytic anemia, glossitis, peripheral neuropathy, weakness, hyperreflexia, ataxia, and other neurological manifestations characterize classical vitamin B12 (cobalamin) deficiency. It is common, however, to encounter patients with vitamin B12 deficiency who have atypical clinical or laboratory features.