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found that supplementation with folic acid (the synthetic form) in girls with Down syndrome may not be as effective as the active form

According to the Mayo Clinic, most people consume adequate amounts of B vitamins through their diet, though the elderly, particularly those with pernicious anemia, athletes, strict vegetarians, and people who consume a lot of alcohol may be deficient in the B vitamins and may require injections or oral supplementation of B vitamins or vitamin B-12, in particular

B12 then converts this methylmalonyl-CoA mutase into succinyl-CoA in a further step

The reality is that although lipotropic injections work, how well they do so depends on their composition