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In humans, cyanocobalamin must undergo intracellular enzymatic conversion to the active coenzyme formsmethylcobalamin and adenosylcobalaminwhich, depending on the pH environment, can interconvert with hydroxocobalamin ( Despite extensive biochemical knowledge of cobalamin metabolism and its physiological importance, the optimal supplementation route for maintaining or restoring adequate vitamin B12 levels remains debated
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Treatment of B12 deficiency without neurological symptoms involves hydroxocobalamin 1 mg intramuscularly three times weekly for two weeks, then every three months
Chen HL, Tan CT, Wu CC, Liu TC