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Elevated methylmalonic acid is commonly seen in the elderly, either because B12 is poorly absorbed (which may be one of the reasons), or because there is not necessarily a B12 deficiency as such, but rather an alteration in kidney function

Sadowska, G

Gut-microbiota-brain axis and effect on neuropsychiatric disorders with suspected immune dysregulation

12.5 Mechanism of the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) reaction

Cellular Energy and Longevity An in-depth review of NAD+ (nicotinamide adenine dinucleotide) research covering its role in cellular energy metabolism, DNA repair, sirtuin biology, and ageing research