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Methylmalonic aciduria and homocystinuria type C protein convert cyanocobalamin into the active methylcobalamin and adenosylcobalamin forms in cells, as long as there is no remethylation disorder cblC in methylmalonic aciduria and homocystinuria type C protein, cblF and cblJ in the protein integral membrane of lysosomal cobalamin transport-escort protein LMBD1 and ATP-binding cassette subfamily D member 4—required for lysosomal release of transport of cobalamin

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Kahn also calls the peptide category a “bit of a gray zone,” given its uncertain regulatory status, but says she wants to emphasize that patients cannot simply buy peptides from compounding pharmacies