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Some disorders of intracellular cobalamin metabolism (cblC, cblD-MMA/Hcy, cblF, and cblJ) do not only compromise the synthesis of methylcobalamin, but also the synthesis of adenosylcobalamin, cofactor of the enzyme methylmalonyl-CoA mutase, leading to elevated concentrations of both tHcy and methylmalonic acid (MMA)

PMID 9250994

Once you achieve the desired results with a given dose, you continue taking that dose or a slightly lower one as a maintenance dose to keep the drug level steady in the body and sustain the effect over time without causing toxicity

doi: 10.1074/jbc.R800046200 13 ShindouHHishikawaDHarayamaTYukiKShimizuT

The clinical signs and symptoms of cobalamin-related remethylation disorders may vary considerably and affect multiple organ systems, most prominently the nervous system and the bone marrow

Saudy HS, El-Bially MA, Hashem FA, Shahin MG, ElGabry YA (2023a) The changes in yield response factor, water use efficiency, and physiology of sunflower owing to ascorbic and citric acids application under mild deficit irrigation