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The failure of methionine synthesis due to cobalamin deficiency may either (1) lead to an accumulation of 5-methyl-tetrahydrofolate, trapping folate in a chemical form unusable in purine synthesis (the "folate trap" hypothesis) or (2) impair methylation reactions needed to produce formyl-tetrahydrofolate, a precursor to 5,10-methylene tetrahydrofolate
Armstrong MJ, Hull D, Guo K, et al
Patients should speak to their GP if their BMI is 30 or above (or 27.5 or above in certain ethnic groups with higher metabolic risk), particularly if they have related conditions such as type 2 diabetes, hypertension, or sleep apnoea
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