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It typically presents as macrocytic megaloblastic anemia and neurological impairments, including sensory and motor disfunctions, predominantly in the lower extremities, ataxia, and in more advanced stages cognitive decline progressing to dementia, as well as psychiatric disturbances ( Subclinical B12 deficiency, however, is far more prevalent, affecting up to 26% of the general population

Synthesised via solid-phase peptide synthesis, it consists of the sequence Tyr-hGH, which preserves part of the original hormones secondary structure but operates independently of classical hGH receptor binding

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However, two other forms hydroxocobalamin and cyanocobalamin become biologically active after they are converted to methylcobalamin or 5-deoxy adenosylcobalamin, said Dr Aravinda G M, consultant, internal medicine, Manipal Hospital, Jayanagar, Bangalore

Younger people can also become deficient, particularly if they don't eat a balanced, nutrient-rich diet