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Several mechanisms have been suggested [5,17,33,34]: (1) reduced intrinsic factor secretion, (2) decreased vitamin B12 release from protein complexes, (3) microbial overgrowth due to slowed intestinal transit, and (4) decreased vitamin B12-intrinsic factor complex receptors

For example, Lee and colleagues reported that individuals with long COVID had higher levels of DNA methylation in certain genes involved in immune response and inflammation 11

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The MTHFR gene produces an enzyme that helps regulate homocysteine levels in the body, and when this process is impaired due to a genetic variation, we can end up with higher levels of homocysteine