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* Correspondence: Serge Chooklin, [email protected] These authors have contributed equally to this work and share first authorship Disclaimer All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers

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In this metabolic pathway, the cofactor carnitine is crucial since it serves as a shuttle-molecule to allow fatty acid acyl moieties entering the mitochondrial matrix where these molecules are oxidized via the -oxidation pathway

When intrinsic factor function is reduced, the high potency 5000mcg dose ensures that passive diffusion alone delivers a meaningful amount of B12, making this formula effective across a wide range of absorption capacities

Inhibition of this transfer worsens outcomes, suggesting a glia-to-neuron mitochondrial rescue pathway (Hayakawa et al., 2016)