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Cyanocobalamin is the most widely available synthetic form, is shelf-stable, and is FDA-approved for treating B12 deficiency

1 Introduction Osteoarthritis (OA) is among the most prevalent degenerative joint diseases globally, affecting more than 500 million people worldwide and ranking as the leading cause of disability among adults aged 50 years and older ( Ferroptosis, first reported in 2012, is a novel form of cell death distinct from classical apoptosis, pyroptosis, and necrosis ( Due to the possible critical role of ferroptosis in OA, there has been a surge of interest in elucidating its molecular mechanisms and exploring potential therapeutic strategies

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A portion of pyruvate enters the mitochondria where it is used to fuel energy production via the citric acid cycle and oxidative phosphorylation (OXPHOS)