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This is particularly important if you are part of any of the groups considered to be at high risk of B12 deficiency, including alcoholics, smokers, those on diabetes drugs, adults over 65, those with gastrointestinal disorders and those who have had surgery relating to the digestive tract

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Always follow proper handling guidelines and dosage instructions outlined by your scientific institution

You might also face difficulties getting the B12 you need if you have Celiac disease or Crohns disease, or if you are vegetarian or vegan

Two downstream consequences are mechanistically central: nicotinamide is preserved for re-entry into the NAD+ salvage pathway (raising intracellular NAD+ availability), and SAM is preserved for other methylation reactions