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Furthermore, RA is also thought to be driven by a generation of neoantigens through post-translational modifications of proteins, most commonly by citrullination (also known as deimination)the replacement of the ketamine group in arginine with a ketone group, which effectively removes the positive charge of arginine at neutral pH and converts arginine to the non-coded amino acid citrulline [208, 209]

a cell culture study

The same may be true of folic acid, which is commonly taken in supplement form during pregnancy, per a 2022 study published in Advances in Nutrition

Having said that some patients do get a paradoxical response to B12 and present with fatigue, headaches, and flu-like symptoms