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A deficiency in either of these vitamins can cause a wide range of problems, including: extreme tiredness a lack of energy pins and needles (paraesthesia) a sore and red tongue mouth ulcers muscle weakness disturbed vision psychological problems, which may include depression and problems with memory, understanding and judgement Some of these problems can also happen if you have a deficiency in vitamin B12 or folate but do not have anaemia

In the UK, hydroxocobalamin injections are prescription-only medicines and should only be administered when clinically indicated

Altered Cbl metabolism due to genetic variations may affect DNA methylation, gene expression, and the overall health of nerve cells, potentially influencing the risk and outcomes of MS

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