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Abbreviations FA Fatty Acid TAG Triacylglycerol LD Lipid Droplet BAT Brown Adipose Tissue PNPLA Phospholipase domain containing ATGL Adipocyte triglyceride lipase HSL Hormone Sensitive Lipase MGL Monoacylglycerol Lipase T2D Type 2 Diabetes FLD Fatty Liver Disease ABHD5 alpha/beta hydrolase domain-containing protein 5 CDS Chanarin-Dorfman Syndrome PLIN1 Perilipin 1 PAT perilipin/ADRP/TIP47 DAG Diacylglycerol G0S2 G0/G1 switch gene 2 PPAR peroxisome proliferator-activated receptor HILPDA Hypoxia-inducible lipid droplet-associated protein HID2 Hypoxia inducible protein 2 MAG Monoacylglycerol LPAAT lysophosphatidic acid acyltransferase -ARs - adrenergic receptors cAMP cyclic AMP UCP1 uncoupling protein 1 KO knockout Ces3 Carboxylesterase 3 FAO fatty acid oxidation ANP Atrial Natriuretic Peptide BNP B-type Natriuretic Peptide PKG Protein Kinase G NPCR NP Clearance Receptor NPR-A natriuretic peptide receptor-A cGMP cyclic GMP WAT white adipose tissue IRS insulin receptor substrate PI3-K phosphatidylinositol 3-kinase PDE3B phosphodiesterase 3 B LC-CoA long-chain acyl-CoA UPS ubiquitin- proteasome system CMA chaperone-mediated autophagy ERAD ER-associated degradation VCP valosin-containing protein LPA lysophosphatidic acid SIRT1 Sirtuin1 FABP Fatty acid binding protein CREBH cAMP responsive element binding protein H ER Endoplasmic Reticulum VLDL Very low-density lipoprotein FGF21 Fibroblast growth factor 21 FAHFA Fatty acid ester of hydroxyl fatty acid EVs extracellular vesicles PKC protein kinase C HFD high fat diet DES1 dihydroceramide desaturase 1 NASH Non-alcoholic steatohepatitis FAS Fatty acid synthase PGE2 prostaglandin E2 LLC Lewis lung carcinoma CAC cancer-associated cachexia ADMR adrenomedullin receptor PTHrP parathyroid hormone-related protein Footnotes Competing Interests The authors declare that there are no competing interests

G., Fored, M

Individuals who follow a strict vegan diet are at a higher risk since they exclude animal products such as meat, fish, eggs, and milk, which are rich sources of B12

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Dose needs to be escalated by 0.25 mg every four weeks till patient reaches the max dose of 2.4 mg OR patient cannot tolerate dose escalation due to side effects

For therapy monitoring: A decreasing MMA level after starting B12 treatment confirms that the therapy is working and that the vitamin is reaching the cells