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DOI: 10.1213/ANE.0b013e3181d41512 stergaard D et al (1989): Adverse Reactions and Interactions of the Neuromuscular Blocking Drugs

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The degradation of folate was shown to be affected by temperature and dependent on the drying time shorter drying time at a higher temperature can limit vitamin decomposition mediated by thermal degradation

The American Academy of Family Physicians and NIH identify the following clinical manifestations: Fatigue and generalized weakness Megaloblastic anemia (abnormally large, immature red blood cells) Tingling or numbness in the hands and feet (peripheral neuropathy) Difficulty walking and balance problems Cognitive disturbances including memory difficulty and confusion Mood changes, including depression and irritability Glossitis (swollen, inflamed tongue) Early symptoms such as fatigue and mild tingling are often attributed to stress, aging, or other conditions