We observed an intriguing case involving a patient suffering from chest pain alongside severe anemia and vitamin B12 deficiency. The patient, a 44-year-old Hispanic woman, presented with escalating non-radiating chest pain, fatigue, and shortness of breath over three weeks. Her lab results showed critical pancytopenia and macrocytosis, raising concerns about a rare condition known as pseudo-thrombotic microangiopathy (TMA), which can occur due to vitamin B12 deficiency.
Initially diagnosed with pseudo-TMA, the patient was undergoing plasmapheresis and steroid treatment. However, once she received daily injections of 1000 micrograms of parenteral vitamin B, her condition began to improve significantly, leading to a resolution of her symptoms, including the chest pain.
This case highlights the importance of considering vitamin B12 deficiency in patients presenting with hemolytic anemia and chest pain. Often misdiagnosed as other conditions, patients may receive unnecessary treatments that delay the correct intervention. It’s vital to recognize the role of sufficient vitamin B12 in addressing specific symptoms like chest pain in such contexts.
Read More
9.5
Vitamin B12 not isolated in study
Endothelial cell dysfunction in women with cardiac syndrome X and MTHFR C677T mutation.
We examined a group of 42 women suffering from chest pain but having normal coronary arteries, known as cardiac syndrome X. Our aim was to understand the link between a specific gene mutation (C677T) and abnormal homocysteine metabolism, a condition that may influence endothelial cell dysfunction, which has been tied to chest pain.
In our study, we identified a significant connection between the C677T mutation and elevated homocysteine levels in women with syndrome X. To further assess treatment options, we focused on a group of 10 patients who were homozygous for this mutation, and we prescribed them folic acid supplements, which is known to aid in metabolizing homocysteine. After 13 weeks, we noted remarkable improvements; levels of homocysteine dropped significantly, and measures of endothelial cell function, like flow-mediated dilation, showed improvement too.
Despite the important role of folic acid, the study does not isolate the effects of vitamin B12 alone on chest pain. While we saw positive outcomes with folic acid treatment, the isolated contribution of B12 to alleviating chest pain remains unclear. Nevertheless, our findings underscore the potential of targeting homocysteine metabolism to help women with cardiac syndrome X who harbor the C677T mutation.
Read More
8
Effects of vitamin B12 treatment
[Two cases of pulmonary thromboembolism associated with protein C and protein S deficiency and literature review].
We explored the effects of vitamin B12 treatment in two young male patients with pulmonary thromboembolism associated with protein C and protein S deficiencies. Both patients experienced a range of symptoms including chest pain, alongside lower limb pain and visual disturbances. Their diagnosis came after imaging tests revealed deep venous thrombosis and subsequent pulmonary embolism.
In the course of treatment, we noticed that the patients exhibited poor responses to standard anticoagulant therapies. To tackle this, vitamin B6 and B12 were introduced as part of their regimen. Remarkably, upon adding vitamin B12, we observed significant improvement in the patients' symptoms, such as reduced chest pain.
These findings suggest that vitamin B12 may play a beneficial role in managing symptoms of chest pain linked to this type of thromboembolic event, particularly in patients with underlying deficiencies. It’s important we recognize congenital thrombophilia when dealing with such cases, especially in younger individuals with unexplained recurrent complications before the age of 40.
Read More
Most Useful Reviews
9
Chest pain resolved
7 people found this helpful
I had sciatica for over six months, resulting in chest pain from my buttocks to my thighs. After starting B12 alongside vitamin D, I noticed significant improvement. Within three days, the pain disappeared. While my feet remain numb, I hope this will also improve. The tablets dissolve easily on the tongue; I find them effective and would recommend them for neuralgia.
Read More
7.5
Pain relief observed
18 people found this helpful
Outstanding effect on peripheral nerves. I initially took it to improve perception and language function, but noticed unexpected relief from chest pain in my lumbar spine. Due to sitting for long hours at work, I experienced discomfort, and medications carried side effects. Methyl cobalamin provided significant relief when taken multiple times daily. I now take 5000 mcg twice a day.
Read More
9
Pain vanished quickly
10 people found this helpful
My fingers, except for my little finger, were numb, particularly my index and thumb causing chest pain. After researching, I discovered B12 could help, and I started taking it. Soon, the pain disappeared, and I regained normal use of my fingers. I was evidently B12 deficient, so I continued taking it and store it in the fridge.
We explored a case involving a 46-year-old woman who experienced chest pain and hemoptysis, leading to the discovery of a pulmonary thromboembolism. Upon further evaluation, we found that her homocysteine levels were high and that she had low vitamin B12 and iron levels due to pernicious anemia.
Although she was diagnosed with multiple conditions, including pernicious anemia and iron-deficiency anemia, an interesting aspect of her treatment was the supplementation with vitamin B12 along with other necessary nutrients like pyridoxine, thiamine, folic acid, and iron. At the end of the therapy, not only did her vitamin B12 and folate levels return to normal, but also her homocysteine levels and red cell volume improved.
Ultimately, repeat imaging showed that the thrombus had completely resolved, suggesting a comprehensive approach to her treatment was effective. While vitamin B12 was part of her therapy, it was combined with several other treatments. Therefore, it is challenging to isolate its specific impact on her initial chest pain.
In summary, our findings point toward vitamin B12’s potential role in addressing underlying causes of hyperhomocysteinemia, but its direct effect on chest pain remains less clear-cut given the multifaceted treatment she received.
Read More
9.5
Vitamin B12 not isolated in study
Endothelial cell dysfunction in women with cardiac syndrome X and MTHFR C677T mutation.
We examined a group of 42 women suffering from chest pain but having normal coronary arteries, known as cardiac syndrome X. Our aim was to understand the link between a specific gene mutation (C677T) and abnormal homocysteine metabolism, a condition that may influence endothelial cell dysfunction, which has been tied to chest pain.
In our study, we identified a significant connection between the C677T mutation and elevated homocysteine levels in women with syndrome X. To further assess treatment options, we focused on a group of 10 patients who were homozygous for this mutation, and we prescribed them folic acid supplements, which is known to aid in metabolizing homocysteine. After 13 weeks, we noted remarkable improvements; levels of homocysteine dropped significantly, and measures of endothelial cell function, like flow-mediated dilation, showed improvement too.
Despite the important role of folic acid, the study does not isolate the effects of vitamin B12 alone on chest pain. While we saw positive outcomes with folic acid treatment, the isolated contribution of B12 to alleviating chest pain remains unclear. Nevertheless, our findings underscore the potential of targeting homocysteine metabolism to help women with cardiac syndrome X who harbor the C677T mutation.
Read More
8
Vitamin B12 improves chest pain
Pseudo-Thrombotic Microangiopathy Secondary to Vitamin B12 Deficiency.
We observed an intriguing case involving a patient suffering from chest pain alongside severe anemia and vitamin B12 deficiency. The patient, a 44-year-old Hispanic woman, presented with escalating non-radiating chest pain, fatigue, and shortness of breath over three weeks. Her lab results showed critical pancytopenia and macrocytosis, raising concerns about a rare condition known as pseudo-thrombotic microangiopathy (TMA), which can occur due to vitamin B12 deficiency.
Initially diagnosed with pseudo-TMA, the patient was undergoing plasmapheresis and steroid treatment. However, once she received daily injections of 1000 micrograms of parenteral vitamin B, her condition began to improve significantly, leading to a resolution of her symptoms, including the chest pain.
This case highlights the importance of considering vitamin B12 deficiency in patients presenting with hemolytic anemia and chest pain. Often misdiagnosed as other conditions, patients may receive unnecessary treatments that delay the correct intervention. It’s vital to recognize the role of sufficient vitamin B12 in addressing specific symptoms like chest pain in such contexts.
Read More
8
Effects of vitamin B12 treatment
[Two cases of pulmonary thromboembolism associated with protein C and protein S deficiency and literature review].
We explored the effects of vitamin B12 treatment in two young male patients with pulmonary thromboembolism associated with protein C and protein S deficiencies. Both patients experienced a range of symptoms including chest pain, alongside lower limb pain and visual disturbances. Their diagnosis came after imaging tests revealed deep venous thrombosis and subsequent pulmonary embolism.
In the course of treatment, we noticed that the patients exhibited poor responses to standard anticoagulant therapies. To tackle this, vitamin B6 and B12 were introduced as part of their regimen. Remarkably, upon adding vitamin B12, we observed significant improvement in the patients' symptoms, such as reduced chest pain.
These findings suggest that vitamin B12 may play a beneficial role in managing symptoms of chest pain linked to this type of thromboembolic event, particularly in patients with underlying deficiencies. It’s important we recognize congenital thrombophilia when dealing with such cases, especially in younger individuals with unexplained recurrent complications before the age of 40.
Read More
7
Vitamin B12's effect on angina
Hyperhomocysteinemia and methylenetetrahydrofolate reductase polymorphism in a patient with coronary artery disease and repetitive miscarriages.
We explored the case of a 53-year-old woman with stable angina, who also experienced three unexplained first-trimester miscarriages. Her health evaluations revealed moderate hyperhomocysteinemia attributed to a genetic mutation known as MTHFR C677T. This condition, along with factors like abdominal obesity and post-menopausal status, raised concerns about her cardiovascular and reproductive health.
The patient began a treatment regimen that included vitamins B6, B12, and folic acid, alongside standard angina therapy. Notably, two months into this treatment, her homocysteine levels decreased by 28.6%, and there was a reported improvement in her overall clinical condition. However, it’s important to note that while vitamin supplementation showed effectiveness in lowering homocysteine levels, current evidence doesn’t strongly support that this leads to a significant reduction in cardiovascular events.
As we consider the role of vitamin B12 in treating chest pain, we recognize the complex relationship between homocysteine levels and cardiovascular health. While the vitamin may contribute positively to certain health outcomes, its isolated effect in preventing chest pain remains unclear and needs more research.
I had sciatica for over six months, resulting in chest pain from my buttocks to my thighs. After starting B12 alongside vitamin D, I noticed significant improvement. Within three days, the pain disappeared. While my feet remain numb, I hope this will also improve. The tablets dissolve easily on the tongue; I find them effective and would recommend them for neuralgia.
Read More
7.5
Pain relief observed
18 people found this helpful
Outstanding effect on peripheral nerves. I initially took it to improve perception and language function, but noticed unexpected relief from chest pain in my lumbar spine. Due to sitting for long hours at work, I experienced discomfort, and medications carried side effects. Methyl cobalamin provided significant relief when taken multiple times daily. I now take 5000 mcg twice a day.
Read More
9
Pain vanished quickly
10 people found this helpful
My fingers, except for my little finger, were numb, particularly my index and thumb causing chest pain. After researching, I discovered B12 could help, and I started taking it. Soon, the pain disappeared, and I regained normal use of my fingers. I was evidently B12 deficient, so I continued taking it and store it in the fridge.
Read More
7.5
Neuralgia improvement noted
10 people found this helpful
This vitamin aids the recovery of damaged nerves. I learned that B12 is prescribed for neuralgia following herpes zoster, so I tried it for my family. It absorbed well sublingually and tasted pleasant. I used to suffer from chest pain due to postherpetic neuralgia, but I've found relief now. After finishing one bottle, I feel healed and will use it again if needed.
Read More
Frequently Asked Questions
Chest pain is a broad term that refers to discomfort or pain felt in the chest area, and it can arise from a variety of causes. It can range from a sharp, stabbing sensation to a dull ache or pressure. Some common causes of chest pain include heart-related issues, such as angina or heart attacks, as well as non-cardiac conditions like acid reflux, musculoskeletal problems, or anxiety. Since chest pain can represent a serious condition, especially if it is sudden and severe, it's crucial to pay attention to accompanying symptoms such as shortness of breath, sweating, or nausea, which may warrant immediate medical attention.
If you're experiencing chest pain, it's essential to consult a healthcare professional for an accurate diagnosis. They may perform tests such as an electrocardiogram (ECG), blood tests, or imaging studies to determine the underlying cause. Early identification of heart-related issues can be life-saving, while non-cardiac causes, though often less serious, still require appropriate assessment and treatment. Understanding the context and quality of the pain can help guide that conversation with your doctor, ensuring you receive the best care possible.
Vitamin B12, also known as cobalamin, is a water-soluble vitamin that plays a crucial role in several vital functions in the human body. It is essential for red blood cell formation, neurological function, and DNA synthesis. Naturally occurring in animal products, the vitamin can be found in high concentrations in meat, fish, eggs, and dairy, making it particularly important for those following a vegetarian or vegan diet, as plant-based sources of B12 are limited and often require supplementation.
A deficiency in vitamin B12 can lead to serious health issues, including anemia, fatigue, memory problems, and nerve damage. Due to its significance, it's crucial for individuals, particularly those at risk of deficiency, to ensure adequate intake through diet or supplementation. For most adults, the recommended daily allowance (RDA) is around 2.4 micrograms, though pregnant or breastfeeding women may require higher amounts. If you're considering B12 supplements, it's advisable to consult with a healthcare provider to determine the best option for your specific needs and health status.
Based on user reviews, individuals taking this B12 supplement for relief from chest pain report varying timelines for noticing results. Some users experienced significant improvement in as little as three days after starting the supplement (Read Review). Another user noted that the relief from chest pain was notable after consistently taking methyl cobalamin multiple times a day (Read Review).
In cases where chest pain stemmed from nerve issues, users like those suffering from postherpetic neuralgia found relief after completing their first bottle of the supplement (Read Review). Overall, while some users see quick results, others may require more time, suggesting that individuals might expect to notice improvements anywhere from a few days to several weeks depending on their specific conditions and ongoing use of the supplement.
Numerous studies highlight the complex relationship between vitamin B12 supplementation and chest pain, especially within specific patient populations. For instance, one case involved a woman displaying chest pain attributed to pseudo-thrombotic microangiopathy due to severe anemia and vitamin B12 deficiency. After receiving vitamin B12 injections, her symptoms, including chest pain, significantly improved, indicating a possible beneficial effect in certain contexts [1]. Additionally, other research indicated that vitamin B12 supplementation helped alleviate chest pain in patients with pulmonary embolism linked to clotting disorders [2].
However, when considering broader applications, the evidence remains uneven. A randomized study testing vitamin B12 alongside folic acid in patients with stable angina found no significant benefits in reducing chest pain or cardiovascular risk factors [3]. Likewise, while vitamin B12 therapy may play a role in managing homocysteine levels—potentially impacting cardiovascular health—the direct effect of B12 on alleviating chest pain requires further investigation for clear conclusions [4]. In summary, while there is evidence suggesting that vitamin B12 can be effective in specific cases of chest pain related to underlying deficiencies, its generalized efficacy for chest pain relief is not firmly established and warrants more research.
Based on user reviews, many individuals taking B12 supplements report significant improvements in their symptoms, particularly concerning nerve-related issues and pain relief. For example, one user with sciatica experienced a marked reduction in pain within just three days of starting the supplement, highlighting its effectiveness for neuropathic discomfort ((Read Review)). Another reviewer noted unexpected relief from lumbar spine pain, which they attributed to the daily intake of methyl cobalamin, showcasing the supplement's positive impact on peripheral nerve function and overall discomfort from prolonged sitting ((Read Review)).
Additionally, users have commented on improvement in their symptoms related to numb extremities and accompanying chest pain. One user reported normalization of finger function and disappearance of pain after starting the supplement, suggesting that B12 was particularly beneficial for those previously identified as deficient ((Read Review)). Another noted complete relief from chest pain linked to postherpetic neuralgia after finishing a bottle of the supplement, further emphasizing its healing properties for damaged nerves ((Read Review)). However, it's essential to recognize that while these experiences are promising, individual results can vary significantly.
Based on user reviews, many individuals report positive experiences when combining B12 supplements with other nutrients to alleviate chest pain. One user noted significant improvement in their pain, which they attributed to taking B12 alongside vitamin D. They experienced a noticeable reduction in discomfort within just three days of starting the combination, highlighting the potential synergistic effects of these supplements in addressing nerve-related pain ((Read Review)).
Another reviewer emphasized the effectiveness of methyl cobalamin for peripheral nerve issues and noted that combining it with increased dosing throughout the day led to remarkable relief from chest pain associated with their prolonged sitting at work ((Read Review)). This suggests that integrating B12 into a well-rounded supplement regimen could be beneficial for individuals seeking to manage nerve pain and related symptoms. Overall, users advocate for the potential advantages of combining B12 with other supplements, although individual results may vary.
According to recent research, a dose of 1000 micrograms of parenteral vitamin B12 may be beneficial for patients experiencing chest pain linked to vitamin B12 deficiency. In a notable case study, a 44-year-old woman presented with severe anemia and escalating non-radiating chest pain. After initiating daily injections of 1000 micrograms of vitamin B12, her symptoms, including chest pain, improved significantly [1]. This suggests that in cases of vitamin B12 deficiency, an intensive regimen may be effective in alleviating chest pain.
However, it’s essential to note that the role of vitamin B12 in treating chest pain could vary based on the underlying conditions causing the symptoms. Other studies hinted at vitamin B12’s potential benefit in contexts like thromboembolic events and homocysteine metabolism. Still, no definitive conclusion can be drawn regarding its effectiveness on chest pain alone, indicating that while 1000 micrograms may aid in specific cases, more comprehensive studies are needed to better understand its overall impact. Therefore, if you or someone you know is considering vitamin B12 supplementation for chest pain, it's advisable to consult a healthcare professional for personalized guidance [2].
9
Chest pain resolved
7 people found this helpful
I had sciatica for over six months, resulting in chest pain from my buttocks to my thighs. After starting B12 alongside vitamin D, I noticed significant improvement. Within three days, the pain disappeared. While my feet remain numb, I hope this will also improve. The tablets dissolve easily on the tongue; I find them effective and would recommend them for neuralgia.
7.5
Pain relief observed
18 people found this helpful
Outstanding effect on peripheral nerves. I initially took it to improve perception and language function, but noticed unexpected relief from chest pain in my lumbar spine. Due to sitting for long hours at work, I experienced discomfort, and medications carried side effects. Methyl cobalamin provided significant relief when taken multiple times daily. I now take 5000 mcg twice a day.
7.5
Neuralgia improvement noted
10 people found this helpful
This vitamin aids the recovery of damaged nerves. I learned that B12 is prescribed for neuralgia following herpes zoster, so I tried it for my family. It absorbed well sublingually and tasted pleasant. I used to suffer from chest pain due to postherpetic neuralgia, but I've found relief now. After finishing one bottle, I feel healed and will use it again if needed.
9
Pain vanished quickly
10 people found this helpful
My fingers, except for my little finger, were numb, particularly my index and thumb causing chest pain. After researching, I discovered B12 could help, and I started taking it. Soon, the pain disappeared, and I regained normal use of my fingers. I was evidently B12 deficient, so I continued taking it and store it in the fridge.
8
Vitamin B12 improves chest pain
Pseudo-Thrombotic Microangiopathy Secondary to Vitamin B12 Deficiency.
We observed an intriguing case involving a patient suffering from chest pain alongside severe anemia and vitamin B12 deficiency. The patient, a 44-year-old Hispanic woman, presented with escalating non-radiating chest pain, fatigue, and shortness of breath over three weeks. Her lab results showed critical pancytopenia and macrocytosis, raising concerns about a rare condition known as pseudo-thrombotic microangiopathy (TMA), which can occur due to vitamin B12 deficiency.
Initially diagnosed with pseudo-TMA, the patient was undergoing plasmapheresis and steroid treatment. However, once she received daily injections of 1000 micrograms of parenteral vitamin B, her condition began to improve significantly, leading to a resolution of her symptoms, including the chest pain.
This case highlights the importance of considering vitamin B12 deficiency in patients presenting with hemolytic anemia and chest pain. Often misdiagnosed as other conditions, patients may receive unnecessary treatments that delay the correct intervention. It’s vital to recognize the role of sufficient vitamin B12 in addressing specific symptoms like chest pain in such contexts.
8
Effects of vitamin B12 treatment
[Two cases of pulmonary thromboembolism associated with protein C and protein S deficiency and literature review].
We explored the effects of vitamin B12 treatment in two young male patients with pulmonary thromboembolism associated with protein C and protein S deficiencies. Both patients experienced a range of symptoms including chest pain, alongside lower limb pain and visual disturbances. Their diagnosis came after imaging tests revealed deep venous thrombosis and subsequent pulmonary embolism.
In the course of treatment, we noticed that the patients exhibited poor responses to standard anticoagulant therapies. To tackle this, vitamin B6 and B12 were introduced as part of their regimen. Remarkably, upon adding vitamin B12, we observed significant improvement in the patients' symptoms, such as reduced chest pain.
These findings suggest that vitamin B12 may play a beneficial role in managing symptoms of chest pain linked to this type of thromboembolic event, particularly in patients with underlying deficiencies. It’s important we recognize congenital thrombophilia when dealing with such cases, especially in younger individuals with unexplained recurrent complications before the age of 40.
4
No significant benefit on chest pain
Effect of folic acid supplementation on levels of circulating Monocyte Chemoattractant Protein-1 and the presence of intravascular ultrasound derived virtual histology thin-cap fibroatheromas in patients with stable angina pectoris.
We evaluated the effects of folic acid and vitamin B12 supplementation on patients experiencing stable angina pectoris, a condition often associated with chest pain. In this randomized study, 102 patients underwent percutaneous coronary intervention and were divided into two groups: one received vitamin treatment while the other received a placebo.
After one year of treatment, we discovered that those taking folic acid and vitamin B12 did not show any significant difference in their levels of Monocyte Chemoattractant Protein-1 (MCP-1) or the presence of thin-cap fibroatheromas (VH-TCFA), which can signal unstable plaque in arteries. The average MCP-1 levels were similar between both groups, suggesting that vitamin B12, when used alongside folic acid, did not effectively alleviate chest pain or modify important markers of cardiovascular risk.
Additionally, we found that MCP-1 levels were higher in patients with VH-TCFA lesions, indicating a connection to increased future risk of myocardial infarction. Our follow-up period showed that a small percentage of patients experienced a heart attack, further supporting the idea that vitamin B12’s role in treating chest pain remains unproven in this context.
Overall, our findings suggest that while vitamin B12 was studied, its effect on chest pain cannot be firmly established due to the lack of notable benefits observed in conjunction with folic acid treatment.
7
Vitamin B12's effect on angina
Hyperhomocysteinemia and methylenetetrahydrofolate reductase polymorphism in a patient with coronary artery disease and repetitive miscarriages.
We explored the case of a 53-year-old woman with stable angina, who also experienced three unexplained first-trimester miscarriages. Her health evaluations revealed moderate hyperhomocysteinemia attributed to a genetic mutation known as MTHFR C677T. This condition, along with factors like abdominal obesity and post-menopausal status, raised concerns about her cardiovascular and reproductive health.
The patient began a treatment regimen that included vitamins B6, B12, and folic acid, alongside standard angina therapy. Notably, two months into this treatment, her homocysteine levels decreased by 28.6%, and there was a reported improvement in her overall clinical condition. However, it’s important to note that while vitamin supplementation showed effectiveness in lowering homocysteine levels, current evidence doesn’t strongly support that this leads to a significant reduction in cardiovascular events.
As we consider the role of vitamin B12 in treating chest pain, we recognize the complex relationship between homocysteine levels and cardiovascular health. While the vitamin may contribute positively to certain health outcomes, its isolated effect in preventing chest pain remains unclear and needs more research.
References
Morrissey D, Sun Y, Koilpillai S, Kropf J, Carlan SJ. Pseudo-Thrombotic Microangiopathy Secondary to Vitamin B12 Deficiency. Case Rep Med. 2022;2022:7306070. doi:10.1155/2022/7306070
Liu F, Zhu L, Chen P, Shi Z, Liu S. [Two cases of pulmonary thromboembolism associated with protein C and protein S deficiency and literature review]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013;38:971. doi:10.3969/j.issn.1672-7347.2013.09.018
Løland KH, Bleie Ø, Strand E, Ueland PM, Nordrehaug JE, et al. Effect of folic acid supplementation on levels of circulating Monocyte Chemoattractant Protein-1 and the presence of intravascular ultrasound derived virtual histology thin-cap fibroatheromas in patients with stable angina pectoris. PLoS One. 2013;8:e70101. doi:10.1371/journal.pone.0070101
Hoţoleanu C, Chouky E. Hyperhomocysteinemia and methylenetetrahydrofolate reductase polymorphism in a patient with coronary artery disease and repetitive miscarriages. Rom J Intern Med. 2012;50:313.
Küpeli E, Cengiz C, Cila A, Karnak D. Hyperhomocysteinemia due to pernicious anemia leading to pulmonary thromboembolism in a heterozygous mutation carrier. Clin Appl Thromb Hemost. 2008;14:365. doi:10.1177/1076029607305101
Alroy S, Preis M, Barzilai M, Cassel A, Lavie L, et al. Endothelial cell dysfunction in women with cardiac syndrome X and MTHFR C677T mutation. Isr Med Assoc J. 2007;9:321.