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Several factors can influence how the MTHFR gene works, resulting in either a clean MTHFR that functions properly or a dirty MTHFR that can cause various health issues

doi:10.1002/14651858.CD004655.pub3 Devalia V, Hamilton MS, Molloy AM

Minimizing Methylmalonic Acid Levels A potential problem with the IOMs method for determining B12 requirements (see Institute of Medicines Recommendations above), is that a small percentage of people with neurological symptoms of B12 deficiency have normal blood parameters, including 13% of patients in one series of case studies (Lindenbaum, 1988)

[DOI] [PMC free article] [PubMed] [Google Scholar] 77.Perello M, Dickson S