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This leads to a deficiency of the vitamin and consequently, a type of anemia known as megaloblastic anemia

Also it occurs at an activated carbon atom, that is next to sp , sp2 carbons: Oxidative Phase-I involving cytochrome P-450 enzymes: Aliphatic hydroxylation: Mainly occur on the ultimate () or penultimate (-1) carbon atom in the structure

ALCAR can cross the blood-brain barrier, which is one reason its been studied in research related to cognitive function

However, Ferguson et al (1999) reported that the reaction between homocysteine thiolactone and LDL generates an LDL adduct that is more resistant to oxidative modification than native LDL