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methylmalonyl CoA mutase converts methylmalonyl CoA to succinyl CoA, with 5-deoxy adenosyl cobalamin required as a cofactor

Intramuscular B is the standard treatment

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Chemotherapy with drugs like 5-fluorouracil has also been associated with acute thiamine deficiency by disrupting thiamine activation, so oncology patients receiving such therapy might receive parenteral thiamine supplementation as part of this B-Complex if needed