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In extreme cases, lack of B12 can damage the optic nerve or plug up the blood vessels in the retina, causing blurry vision, double vision, sensitivity to light, and even vision loss

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In the rare congenital recessive syndrome of selective malabsorption of folate due to mutation of the proton-coupled folate transporter (PCFT), there is an associated defect of folate transport into the cerebrospinal fluid, and these patients show megaloblastic anemia, which responds to physiologic doses of folic acid given parenterally but not orally

In the US, people usually use kratom as a liquid