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The biomarker methylmalonic acid in urine is sensitive, detecting early functional vitamin B12 deficiency before the onset of macrocytic anemia, as noted for MMA in serum

How does NAD+ Injection work in the body

Produce antibodies

Risk Statement: Administration of subpotent Hydroxocobalamin in infants, pregnant/breastfeeding women, and elderly populations are at risk for vitamin B12 deficiency and there is a reasonable probability they could experience adverse events including muscle weakness, neurological peripheral neuropathic numbness or pain, vision loss, and psychiatric disorders (depression, memory loss)

Some researchers report strong effects even at 20 mcg daily, while others require higher doses for noticeable results