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Vitamins and Supplements: What to Know Before You Take Herbal SupplementsNot all herbs and supplements are safe, especially if you have certain medical conditions or take some drugs

The magnitude of the NAD + -elevation effect of NNMT inhibition in vivo, and its contribution to the metabolic phenotype relative to the methylation effects, remains an active area of research

Sci Rep 12 , 484 (2022)

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So if you took B12 and felt worse, and your blood B12 is elevated, and you have a constellation of symptoms across multiple systems that's three signals pointing toward MCAS as worth ruling out