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[139] This could be associated with loss of blood during menstruation, or with pregnancy

Neurology 72:19141921 Griffiths I, Klugmann M, Anderson T, Yool D, Thomson C, Schwab MH, Schneider A, Zimmermann F, McCulloch M, Nadon N, Nave KA (1998) Axonal swellings and degeneration in mice lacking the major proteolipid of myelin

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Although we performed multivariate adjust- ments, residual confounding may persist due to unmea- sured factors such as dietary habits (e.g., irregular intake of animal-derived foods or B12-fortied products), unrecorded use of nutritional supplements, and genetic predispositionsparticularly MTHFR polymorphisms, which are known to inuence homocysteine metabolism and folate cycling, thereby potentially altering the func- tional demand for vitamin B12