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Some patients with multiple recurrent metabolic disorders may develop irreversible neurological damage with residual mental retardation, ataxia, spastic paraplegia, sensorineural hearing loss, optic nerve atrophy, and epilepsy [79, 81]

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Vitamin B12 supplementation is crucial for those with deficiency, often stemming from conditions such as pernicious anaemia or dietary limitations

From a health economics perspective, lifelong B12 supplementation should involve cost-effective delivery routes and tailored dosages to optimise clinical outcomes while minimising excess

Bacteriostatic water is a sterile, non-pyrogenic solution that typically contains a small amount of benzyl alcohol to inhibit bacterial growth, making it suitable for multi-use laboratory applications