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See a clinician to identify whats actually causing your GI troubles

NR treatment increased cerebral NAD + levels and NAD + metabolome in CSF, skeletal muscle, and PBMCs

Additionally, chronic conditions such as HIV and tuberculosis have been implicated in B12 deficiency due to increased metabolic demand and altered absorption mechanisms ( The diagnosis of vitamin B12 deficiency typically relies on low total B12 levels and elevated concentrations of homocysteine (Hcy), as well as levels of transcobalamin-bound B12 (holoTC) and methylmalonic acid (MMA), which serve as functional indicators of cobalamin insufficiency ( Vitamin B12 requirements fluctuate throughout the life course, influenced by metabolic demand and physiological changes

Conversely, if too much niacin is taken, it could cause flushing, redness and also headaches, so dosing is important

B12 Form Choice Should Match the Reason for Treatment Methylcobalamin may be preferred when nerve-related symptoms, methylation issues, or persistent fatigue remain part of the clinical picture