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Homocysteine is important to test in conjunction with MMA as a high level indicates a possible methylcobalamin deficiency, this is the second form of B12 that is important for methylation in the body, along with DNA/ RNA repair

I know there are quite a few variables with oral bioavailability, but assuming taken fasted,

High serum B12 with functional deficiency or discordant symptoms A high total B12 can coexist with a cellular shortage of the vitamin

Are pregnant or breastfeeding

The more pragmatic question is whether peptides can complement biologic therapy, potentially improving outcomes or allowing dose reduction

An open-label, non-randomized study of the pharmacokinetics of the nutritional supplement nicotinamide riboside (NR) and its effects on blood NAD+ levels in healthy volunteers