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In a population-based study of 3884 elderly people, deficiency of vitamin B 12 was associated with almost 70% more likelihood of having a depressive disorder.54 In another cross-sectional study of 700 community-dwelling, physically disabled women aged 65 years, vitamin B 12 deficient women were twice more likely to have severe depressive symptoms.55 Although controlled studies to show response to vitamin B 12 replacement therapy in depression are lacking, it is recommended that all patients with vitamin B 12 deficiency should be managed as part of depression treatment

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DMF treatment was found to significantly increase the metabolism of serine to cystathionine and GSH, compared to hemin treatment alone (Fig