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Here's how it works: Methionine Synthesis: Methylcobalamin acts as a cofactor for an enzyme called methionine synthase

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These peripheral and central deficits can include severe gastrointestinal lesions, intracranial (superior sagittal sinus) hypertension, brain swelling and lesions, portal and caval hypertension, aortic hypotension, peripheral and central thrombosis, inferior caval vein and superior mesenteric vein congestion, azygos vein failure, electrocardiogram (ECG) disturbances, and heart, lung, liver, and kidney lesions (Vukojevic et al., 2018