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All controlled studies referenced below were conducted in cell culture (3T3-L1 adipocytes, primary muscle stem cells) or rodent models (diet-induced obese mice, aged C57BL/6J mice)

The lack of adequate cobalamin in the body hinders the regeneration of tetrahydrofolate, which eventually leads to megaloblastic anemia due to the functional folate deficiency.[9][10] On the other hand, the methylmalonyl-CoA mutase helps to metabolize odd chain fatty acids and branch chain amino acids.[5] Cobalamin is also thought to keep the bodys level of sulfhydryl (SH) groups in reduced form

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They require proper technique, clean supplies, and comfort with needles