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Further, the conversion of both hydroxycobalamin and cyanocobalamin to the active Adenosyl and methyl cobalamins, also involve "Flavoproteins" (Obeid etal, 2015) and hence if a person takes or is injected with, high doses of hydroxycobalamin or cyanocobalamin and has functional B2 deficiency, the inactive hydroxycobalamin and cyanocobalamin will accumulate in serum, however the symptoms of vitamin B12 deficiency will not be resolved

Expert Syst Appl 255:19

Methylmalonic acid (MMA) test: Methylmalonic acid test detects elevated levels of MMA, a compound that increases when there is a deficiency of vitamin B12

The answer turned out to be surprisingly straightforward: Kennedy openly adm

Jensen JK, Zobel EH, von Scholten BJ et al

It is important to note that there is no evidence that opioid treatment is effective for sciatica