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The B12 deficiency itself getting worse, either because not enough unhealthy red blood cells have expired and been replaced by healthy ones (each one of them has a 90 day life-cycle), or because the B12 wasnt injected on a daily schedule

J Cell Biol 183:795803

doi: 10.2147/IDR.S256773 169 LinaniA.BenarousK.Bou-SalahL.YousfiM.Goumri-SaidS

The FTCD gene is located on chromosome 21q22.3 and is composed of 16 exons that generate three alternatively spliced mRNAs, two of which encode the same 541 amino acid protein (isoform A) and the other encodes a protein of 572 amino acids (isoform C)

As regards the pathogenic mechanisms, the occurrence of an oxidant stress (resulting from an impaired homocysteine metabolism, which modifies the redox status of extra- and intracellular thiols and thus alters the intracellular redox potential) might play a central role in moderate hyperhomocysteinemia-mediated vascular disorders