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Research and clinical experience suggest that IV NAD+ produces a sharp but short-lived spike in plasma levels that does not reliably translate to intracellular increases, which is where the therapeutic effect actually happens

Vitamin B12 injections are most clinically appropriate in cases of confirmed vitamin B12 deficiency, malabsorption syndromes including pernicious anaemia or post-gastric surgery, significant symptoms where rapid restoration of vitamin B12 levels is required, or failure of oral supplementation due to poor absorption