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doi: 10.1007/BF01537272

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Homocysteine can then be recycled back to methionine by the enzyme methionine synthase (also known as 5-methyltetrahydrofolate-homocysteine methyltransferase) in a reaction that requires folate in the form of 5-methyltetrahydrofolate as the methyl donor and vitamin B12 in the form of methylcobalamin as a cofactor

The MTHFR C677T polymorphism causes moderate hyperhomocysteinemia, but according to a 1998 study by Brattstrom, the mutation no longer increases the risk of cardiovascular disease [42]

Some possible complications include bleeding, infection, and nerve damage