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Higher-dose oral B12 (e.g., 1000 g daily) is sometimes used but should only be considered under clinical supervision with appropriate monitoring, particularly in cases of malabsorption where intramuscular treatment remains the first-line approach in UK practice

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Overall, it is clear that NAD + fluxes within the cell are complex and dynamic, but the concentrated levels of NAD + in the mitochondria indicate major impacts of the cofactor in this organelle in particular, which will be summarized below

B12 is safe on its own, but a few conditions call for extra care, which is why a provider reviews your history before treatment: Leber's hereditary optic neuropathy, a rare inherited eye condition, where certain forms of B12 may be a concern for the optic nerve