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[21] Within cells, cyanocobalamin is converted to methylcobalamin and 5- deoxyadenosylcobalamin, coenzymes that participate respectively in homocysteine remethylation to methionine and in the isomerization of methylmalonyl-CoA to succinyl CoA, reactions essential for DNA synthesis, erythropoiesis, and myelin maintenance

Although such strategies are promising, the evidence base remains limited, and additional studies, including clinical trials, are needed to establish feasibility, safety, and durability of benefit in humans

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Individuals with a slow metabolism: Those who have slow metabolisms can benefit from the injections, as they provide a metabolic boost