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NAD+ and vitamin B12: Distinct roles in cellular metabolism and energy production

Though vitamin B12 is available in several different forms, research suggests that they are similar in terms of absorption and effectiveness

However, some patients receiving high-dose B12 supplementation or injections may experience adverse reactions, though these relate to the treatment rather than the elevated levels: Possible reactions to B12 supplementation (particularly injections): Skin reactions, including acneiform eruptions or rashes Pruritus (itching) Injection site reactions (with parenteral administration) Rare hypersensitivity reactions Non-specific symptoms such as headaches, dizziness, or gastrointestinal disturbances have been reported by some patients taking B12 supplements, but causality is not well established in clinical evidence

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If the cause is irreversible then parental therapy should be continued for life