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Over 70 countries, including countries of North America, South America, West, East, and Southern Africa, Central and Southeast Asia, Australia, and New Zealand, have implemented mandatory folic acid fortification of foods until 2022, starting with the United States of America in 1998 680,689,690,691,692

However, this simultaneously allows time for hypoxic cells to reoxygenate and any remaining tumor cells to proliferate, reducing the clinical outcome of both treatments (Saggar and Tannock, 2015)

Inflammatory bowel syndrome or diarrhea can happen, making situation worse for cobalamin absorption

Under normal physiological conditions, the labile iron pool maintains iron balance