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Cofactor for L-methylmalonyl-coenzyme A mutase 5-Deoxyadenosylcobalamin is required by the enzyme that catalyzes the conversion of L-methylmalonyl-coenzyme A to succinyl-coenzyme A (succinyl-CoA), which then enters the citric acid cycle ( Figure 2 )

Bundy JD, Li C, Stuchlik P, Bu X, Kelly TN, Mills KT, et al

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The same reaction can occur on protein cysteine, and the formed GSNO group functions as important intermediate in NO metabolism, a critical player in fulfilling the biolgogical function of NO in signal transduction ( S -glutathionylation (Zeng et al., 2001) or thanks to catalytic activity of GGT generate S-nitrosocysteinylglycine that in turn can be cleaved by a membrane dipeptidase thus forming S -nitrosocysteine (S-NO)

Many plaintiffs allege that the manufacturer failed to adequately warn patients and healthcare providers about the risk of severe gastrointestinal side effects, such as gastroparesis and stomach paralysis, as well as vision loss and other complications