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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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Then conduct adequately powered cohort studies or RCTs to definitively determine its efficacy in improving neurodevelopmental outcomes and preventing complications

[11] More generally, improving glucose metabolism has been shown to slow, or even partially reverse, the cognitive decline associated with aging and dementia

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