Vitamin B12 is a cofactor for L-methylmalonyl-CoA mutase, which converts L-methylmalonyl-CoA to succinyl-CoA in the degradation of propionate, an essential biochemical reaction in fat and protein metabolism
Altered B12 handling and reduced clearance in kidney disease, and both cellular release and reduced clearance in liver disease, can raise B12, so supportive renal or hepatic findings make those causes plausible
Acetic acid for peptide reconstitution pharmaceutical-grade solvent, sealed vial
Thyroid medication can produce symptoms of high blood pressure, heart racing, jitteriness, and anxiety, similar to being on a potent stimulant
[ Disclaimer: This article is for informational purposes only and does not constitute medical advice