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When you dont have enough B12 in your blood, you have a high risk of experiencing elevated homocysteine levels

This axis becomes particularly pronounced in PCOS, where hyperandrogenism-driven adipocyte hypertrophy and insulin resistance create a cytokine-saturated, lipotoxic microenvironment that continuously recruits and activates neutrophils [31]

Takahashi T, Takahashi T, et al

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But the problem is, your body doesnt produce vitamin B12

SHANK3 mutations are likely to cause mitochondrial dysfunction in PMS because six mitochondrial genes, including NADH dehydrogenase 1 alpha subcomplex subunit 6 (NDUFA6 ), cytochrome c oxidase assembly ( SCO2 ), tRNA 5-methylaminomethyl-2-thiouridylate methyltransferase ( TRMU ), thymidine phosphorylase ( TYMP ), carnitine palmitoyltransferase 1B ( CPT1B ), and aconitase 2 ( ACO2 ), are adjacent to SHANK3 in the 22q13.3 region [339]