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A recent systematic review and meta-analysis of 21 randomized, placebo-controlled trials examining the effect of B-vitamin supplementation found the supplementation decreased homocysteine concentrations and improved measures global cognitive function but had no effect on individual measures of executive function, information processing speed, or episodic memory (89)
The agency applied the four-factor framework set out in 21 CFR 216.23(c), covering physical and chemical characterisation, safety, evidence of effectiveness, and historical use
However, it is not FDA-approved for human use and cannot legally be marketed as a drug, supplement, or for human consumption
Because 10 to 30 percent of older people may be unable to effectively absorb vitamin B 12 naturally occurring in foods, those older than 50 years should meet their RDA mainly by consuming foods fortified with vitamin B 12 or a supplement containing vitamin B 12
This procedure may be used as a diagnostic injection or as part of ongoing treatment
Importantly, B12 deficiency can occur without anaemia, and some patients may present with neurological symptoms despite having normal haemoglobin levels
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