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By midlife, NAD+ can drop by 50%, exacerbated by inflammation and lifestyle.[14] Factors like poor diet, sedentary behavior, or chronic stress further deplete NAD+ by activating consuming enzymes, creating a vicious cycle

It would be nice if we could come to a greater understanding of how B12 really really works

A deficiency may cause hair loss, but extra B12 only helps if levels are low

[13] In a newly diagnosed vitamin B 12 -deficient patient, normally defined as when serum levels are less than 200 pg/ml, daily IM injections of hydroxocobalamin up to 1,000 g (1 mg) per day are given to replenish the body's depleted cobalamin stores

In rodent models, blocking NNMT with 5-Amino-1MQ led to lower fat mass, more energy burn, and better insulin response all without cutting calories

If you have malabsorption syndrome (such as short bowel syndrome, certain bariatric surgery patients, chronic pancreatitis, or celiac disease that severely impairs nutrient uptake), you might need these injections indefinitely to prevent recurrent deficiencies