This paper evaluates the possible reasons for consistent vitamin B 12 deficiency in chronic toxigenic mold exposures and the synergistic relationships with the possible mycotoxic effects on one-carbon metabolism that lead to the manifestations of clinical neuropathological symptomology. Vitamins are first defined in general and the nutritional sources of vitamin B 12 are evaluated in particular. Since patients with chronic exposures to toxigenic molds manifest vitamin B 12 deficiencies, the role of mycotoxins in vitamin B 12 metabolism is assessed, and since vitamin B 12 plays important biochemical roles in one-carbon metabolism, the synergistic effects with mycotoxins on humans are reviewed. An outline of the proposed mechanism by which mycotoxins disrupt or interfere with the normal functions of vitamin B 12 on one-carbon metabolism is proposed. The overall functions of vitamin B 12 as a source of coenzymes, in intracellular recycling of methionine, in methionine synthase reaction, in the prevention of chromosome breakage, in methylation, and in maintaining a one-carbon metabolic balance are reviewed. Signs, symptoms, and clinical neurological indications of vitamin B 12 deficiency are also cited. By implication and derivation, it is likely that the interruption of the structure and function of vitamin B 12 would in turn interfere with the one-carbon metabolism leading to the neurological manifestations. This review is an attempt to formulate a basis for an ongoing research investigation on the subject.
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