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It is a co-factor for methionine synthase, an enzyme involved in the methylation cycle, which is crucial for the metabolism of amino acids and the production of neurotransmitters

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Finally, if the serum cobalamin concentration at the time of reevaluation is subnormal [lower than normal], further work-up is required to definitively diagnose the underlying disease process and cobalamin supplementation should be continued weekly or bi-weekly