To clarify from the notes an lecture, if a kid has an issue with NH4 build up, Adenosylcobalamin IS the preferred form of B12 is help minimize NH4? Notes to me not clear that if NH4 is up where you would want to use methyl or adenosyl B12.
I have a patient on about 4mg of a combo of hydroxyl/methyl/adenosyl B12 who have very high taurine and NH4 levels and still need B12 support.