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Dosing information Usual Adult Dose for Pernicious Anemia: Initial dose: 100 mcg intramuscularly or deep subcutaneous once a day for 6 to 7 days If clinical improvement and reticulocyte response is seen from the above dosing: 100 mcg every other day for 7 doses, then: 100 mcg every 3 to 4 days for 2 to 3 weeks, then: Maintenance dose: 100 to 1000 mcg monthly Duration of therapy: Life Comments: Administer concomitant folic acid if needed

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Diet, supplements (e.g., niacin, NR), and exercise help, but may not suffice post-40 due to inefficiency and depletion.[18][19] Oral precursors like NMN increase NAD+ but bioavailability varies

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