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They are most often considered as a last resort for consistent supplementation if oral methods prove ineffective at staving off deficiency

At the cellular level, B12 acts as a cofactor for two critical enzymatic reactions: Methionine synthase converts homocysteine to methionine, essential for DNA methylation and synthesis Methylmalonyl-CoA mutase involved in fatty acid metabolism and myelin production By restoring adequate B12 levels, injections enable normal red blood cell maturation in the bone marrow, correcting the megaloblastic anaemia

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Characterization of a cDNA clone for research subjects NAD(+)-specific isocitrate [PMID: 7755589] Laboratory literature summary: Characterization of a cDNA clone for research subjects NAD(+)-specific isocitrate dehydrogenase alpha-subunit and structural comparison