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This approach was selected because deficiency and elevated clinical cutoffs for serum vitamin B12 are established based on disease-related epidemiological data and markers unrelated to fertility. Considering the paucity of data and the frequent co-exposure to other psychoactive substances, conclusions can be hardly drawn regarding the psychiatric/neurological adverse effects of several of the plants included in this article. In addition, self-medication is frequent, as they are available without a prescription, and plant extracts provided by retail herbal stores may also be mislabeled or adulterated (e.g., heavy metals, pharmaceuticals) . Aside from sexual enhancement, these plants often have many other therapeutic applications and can be a part of the everyday diet of individuals. Psychiatric and neurological side effects included headaches and hypnotic effects and were mild. 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