B<sub>12</sub> deficiency: vital aspects and valid clinical applicability of succinate containing cyanocobalamin

The aim of the research is to review the vital pathological processes in B12 insufficiency and the clinical justification for the use of succinate to potentiate the biological activity of cyanocobalamin. It has been shown that one of the possible reasons for the low clinical efficacy of cyanocobalamin is energy deficiency. The energy deficit is caused by a malfunction of the energy metabolism occurring in conditions of low oxygen supply. In the course of clinical studies, it was found that the double injection of succinate containing cyanocobalamin to cows in the highest possible single doses provided rapid normalization of the reserve alkalinity index and ketone bodies. This effect indicated a qualitative improvement in the processes of energy metabolism occurring in the liver. This was also indicated by a decrease in the physiological values of protein and transamination enzymes AlAT and AsAT. On the contrary, the use of pharmacopoeial cyanocobalamin had no significant effect. Thus, there is every reason to believe that the inclusion of sodium succinate in cyanocobalamin is justified, since it allows to qualitatively improve the biological activity of the drug.