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It can bind two different forms of the cobalamin cofactor, with cobalt bonded either to a methyl group (methylcobalamin) or to 5'-deoxyadenosine (adenosylcobalamin). Cobalamin-binding domains are mainly found in two families of enzymes present in animals and prokaryotes, which perform distinct kinds of reactions at the cobalt-carbon bond .
Cyanocobalamin is the most common form used in dietary supplements and food fortification because cyanide stabilizes the molecule against degradation. Methylcobalamin is also offered as a dietary supplement. [12] There is no advantage to the use of adenosylcobalamin or methylcobalamin forms for the treatment of vitamin B 12 deficiency. [20] [21 ...
Treatment should take into account the cause and severity of the condition. [6] Treatment is done by vitamin B 12 supplementation, either by mouth or by injection. [3] Initially in high daily doses, followed by less frequent lower doses, as the condition improves. [3] If a reversible cause is found, that cause should be corrected if possible. [11]
Cyanocobalamin is a form of vitamin B 12 used to treat and prevent vitamin B 12 deficiency except in the presence of cyanide toxicity. [7] [8] [2] The deficiency may occur in pernicious anemia, following surgical removal of the stomach, with fish tapeworm, or due to bowel cancer.
Methylcobalamin (mecobalamin, MeCbl, or MeB 12) is a cobalamin, a form of vitamin B 12. It differs from cyanocobalamin in that the cyano group at the cobalt is replaced with a methyl group. [1] Methylcobalamin features an octahedral cobalt(III) centre and can be obtained as bright red crystals. [2]
Benfotiamine has been studied in laboratory models of diabetic retinopathy, neuropathy, and nephropathy. [10] A 2021 review of its use for diabetic polyneuropathy described two clinical trials which showed improvements in neuropathic pain and neuropathic symptoms scores, the latter of which showed a dose-response effect. [4]
Aerobic pathway that requires oxygen and in which cobalt is inserted late in the pathway; [6] [7] found in Pseudomonas denitrificans and Rhodobacter capsulatus.; Anaerobic pathway in which cobalt insertion is the first committed step towards cobalamin synthesis; [8] [9] [10] found in Salmonella typhimurium, Bacillus megaterium, and Propionibacterium freudenreichii subsp. shermanii.
Hydroxocobalamin is first line therapy for people with cyanide poisoning. [2] Hydroxocobalamin converts cyanide to the much less toxic cyanocobalamin. Cyanocobalamin is renally cleared. The use of hydroxocobalamin became first line due to its low adverse risk profile, rapid onset of action, and ease of use in the prehospital setting. [16]