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Metabolic pathways: B12 is a cofactor in two critical reactions: Methylmalonyl-CoA mutase: Converts methylmalonyl CoA (from odd-chain fatty acids and some amino acids) into succinyl-CoA, which enters the Krebs (TCA) cycle to make ATP (cellular energy)

At the same time, it prevents lipogenesis, the metabolic process that turns extra calories into new fat reserves

Seniors are also more likely to be taking medication that can interfere with the absorption of B12

A laboratory-supported clinical diagnosis of cobalamin deficiency, with hematologic or neurologic changes, implies the presence of long-standing gastrointestinal disease until proven otherwise