In the advanced stages of liver disease, when hepatic metabolism and drug clearance are affected, safety is a concern, and plasma levels of estrogen can be elevated (146)
Age-related considerations Clinical trials included adults across a range of ages, but specific data on elderly populations is limited
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The clinical phenotype is variable and has been classified into neonatal onset forms, with the most severely affected patients presenting with congenital anomalies (Type I) or without anomalies (Type II), and mild and/or later onset (Type III) [138]
The heavy consumption of ethanol for greater than 2 weeks has been reported to reduce the absorption of Methylcobalamin, vitamin B12