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Poor technique, like vigorous shaking, using the wrong solvent, or ignoring sterility, can cause foaming (which risks oxidation), precipitation (insoluble aggregates), or rapid degradation from bacterial byproducts

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The lack of adequate cobalamin in the body hinders the regeneration of tetrahydrofolate, which eventually leads to megaloblastic anemia due to the functional folate deficiency.[9][10] On the other hand, the methylmalonyl-CoA mutase helps to metabolize odd chain fatty acids and branch chain amino acids.[5] Cobalamin is also thought to keep the bodys level of sulfhydryl (SH) groups in reduced form