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Bacteria-derived hydroxocobalamin (OHCbl) and CNCbl are converted in humans to useful coenzyme forms to support metabolic processes such as mitochondrial methylmalonylcoenzyme A mutase conversion of methylmalonic acid (MMA) to succinate to link lipid and carbohydrate metabolism, and activation of methionine synthase, the rate limiting step in the synthesis of methionine

Scientific References Frequently Asked Questions Can taking too much vitamin B12 be harmful

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If there is insufficient (or no) B12 in bloodstream, or it is not linking well with B12 at this stage, your MMA will increase in your bloodstream, and carry on increasing until B12 makes the journey and the required links