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Propionylcarnitine (C3) and its ratios with acetylcarnitine (C3/C2) and palmitoylcarnitine (C3/C16) In addition to the four canonical markers discussed above, vitamin B 12 deficiency leads to accumulation of propionylcarnitine (C3) (Sarafoglou et al., 2011), which is a marker of methylmalonic aciduria and propionic acidemia

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The injected hydroxocobalamin is transported via the bloodstream to tissues throughout the body, where it acts as a cofactor for two critical enzymatic reactions: the conversion of homocysteine to methionine and the conversion of methylmalonyl-CoA to succinyl-CoA