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When stratified by administration route, the mean percentage changes were: Intramuscular (IM): 307% Oral: 285% Sublingual: 199% IM administration showed the highest average B12 increase, although oral and sublingual routes also yielded substantial improvements, supporting their use as effective and less invasive alternatives
Follow the clinical plan and the vial label after opening, especially with multi-dose vials
While true deficiency can cause serious problems, many people end up taking doses far higher than they need
Grossi MG, Belcaro G, Cesarone MR, et al
The metabolism and elimination of NAD+ (and its by-products) could be altered in advanced hepatic or renal dysfunction, and high-dose NAD+ might theoretically affect cardiovascular dynamics, so practitioners generally avoid or closely supervise NAD+ use in such settings
