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[21] Within cells, cyanocobalamin is converted to methylcobalamin and 5- deoxyadenosylcobalamin, coenzymes that participate respectively in homocysteine remethylation to methionine and in the isomerization of methylmalonyl-CoA to succinyl CoA, reactions essential for DNA synthesis, erythropoiesis, and myelin maintenance

However, its important to note that Semaglutide and Tirzepatide are new drugs, and their long term effects are still unknown