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Bacteria-derived hydroxocobalamin (OHCbl) and CNCbl are converted in humans to useful coenzyme forms to support metabolic processes such as mitochondrial methyl malonyl coenzyme A mutase conversion of methylmalonic acid (MMA) to succinate to link lipid and carbohydrate metabolism, and activation of methionine synthase, the rate-limiting step in the synthesis of methionine

Bone Fractures In 2019, a study found an association between high intakes of vitamins B6 and B12 from food and supplements with the risk of hip fracture among postmenopausal women in the Harvard Nurses Health Study

Contraindications include: Sulfa allergy, due to potential sensitivity to methionine derivatives