FIGURE 1.
Vitamin B-12 in 1-carbon metabolism. Vitamin B-12 deficiency prevents remethylation of homocysteine to methionine; results in an accumulation of 5-methyl-THF, or “folate trap,” decreasing the THF pool for synthesis of 10-formyl-THF; and impairs subsequent purine and thymidylate synthesis. MTHFD1, methylenetetrahydrofolate dehydrogenase 1; MTHFR, methylenetetrahydrofolate reductase; MTR, methionine synthase; tHcy, total homocysteine; THF, tetrahydrofolate.