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A total of 462 articles and documents were excluded after the full-text screening, of which 57 were written in languages other than English, and 206 failed to provide significant findings for Homocysteine, vitamin B12, and folate levels

Tian Y, Jiang W, Gao N, Zhang J, Chen W, et al

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Other symptoms may include: Glossitis (sore, red tongue) Mouth ulcers Visual disturbances (rare, due to optic neuropathy, requiring urgent assessment) Gastrointestinal symptoms such as diarrhoea or constipation It is crucial to recognise that neurological damage from B12 deficiency can become irreversible if left untreated for prolonged periods