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Nevertheless, the pooled analysis of 16 trials suggested improvements in the summary measure of patients' global functioning (assessed with the Clinical Global Impressions [CGI-I] scale) after 12 and 24 weeks of (but not after 52 weeks) of ALCAR treatment (1-3 g/day) and in cognitive performance (assessed with the Mini-Mental State Examination [MMSE] scale) after 24 weeks (but not at 12 or 52 weeks) (104)

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These polymorphisms are unrelated to cobalamin metabolism and the elevated MMA levels do not, by themselves, indicate a B12 deficiency (Molloy, 2016)

Useful Diagnostic Tests Serum Vitamin B12 Complete blood count Serum folate