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Shockwave therapy is unlike any other treatment because it treats the source of the problem, which is a lack of healthy blood flow to the penis

It uses a methyl group donated by S-adenosylmethionine (SAM) to methylate nicotinamide a vitamin B3 form that would otherwise be recycled back into NAD+

Management of Metabolic Conditions: For individuals with metabolic disorders, such as folate deficiency or conditions that affect B12 metabolism, B12 injections are often incorporated into treatment plans to optimize vitamin levels

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I also want to note the dosages used here the supplementation is around 110 mg of B12 when reactions have been reported in these case studies