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Yet the consequences are unknown Bioavailability: there are four specific metabolic steps necessary to convert cyanocobalamin into one of the coenzyme forms, which is a clear metabolic disadvantage (3) Utilisation problems: certain hereditary diseases, as well as metabolic disorders, prevent the conversion of cyanocoalamin into the active B12 forms (4) Steals methyl groups: cyanocobalamin requires a methyl group to convert into methylcobalamin, which it takes from the important amino acid S-adenosylmethionine (SAM)

Treatment often includes a mix of medications, supplements, and lifestyle changes

Vitamin D does not interact with other vitamins

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However, high supraphysiological doses of VD are needed to achieve the required 25(OH)VD levels in the blood, because many subjects respond poorly to supplementation