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The sulfenic acid at Cys20 reacts with G-site bound GSH to generate a mixed disulfide (enzyme-S-S-G)

10.3748/wjg.v23.i29.5304 16 DrmicD.SamaraM.VidovicT.MalekinusicD.AntunovicM.VrdoljakB.et al (2018)

Intrahepatic cholestasis most often occurs in diseases involving hepatocellular damage, leakage, or swelling, such as infections (e.g., bacterial cholangiohepatitis, toxoplasmosis, FIP, or other diseases causing inflammation), infiltrative diseases (e.g., lymphoma), metabolic diseases (e.g., hepatic lipidosis), or diseases causing disruption of architecture (e.g., cirrhosis or severe polycystic disease)

Regular monitoring of B12 levels is typically recommended for those receiving ongoing treatment

No established upper limit exists because excess b12 excretes through kidneys without causing harm