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As a cofactor, cobalamins are essential for two cellular reactions: the mitochondrial methylmalonyl-CoA mutase conversion of methylmalonic acid (MMA) to succinate, which links lipid and carbohydrate metabolism, and the activation of methionine synthase, which is the rate-limiting step in the synthesis of methionine from homocysteine and 5-methyltetrahydrofolate
use caution in Lebers hereditary optic neuropathy and discuss risks if youve had B6-related neuropathy or severe kidney disease
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