Shah Y et al
The leading cause of death was identified based on the International Classification of Diseases, 10th Revision (ICD-10), including death due to cardiovascular disease (heart disease: I00-I09, I11, I13, I20-I51, and cerebrovascular disease: I60-I69), malignant neoplasms (C00-C97)
A 2021 systematic review of 16 randomized controlled trials and 6,276 participants (Markun and colleagues, Effects of Vitamin B12 Supplementation on Cognitive Function, Depressive Symptoms, and Fatigue, Nutrients, 2021) found that B12 supplementation does not reliably reduce fatigue in people who are not deficient
You must not be given Cobal-B12 injection if you have had an allergy to: Symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing
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Therefore, the homocysteine level may not rise enough to the abnormal range in a person with Down syndrome with a decrease in vitamin B12 or folate activity