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NAD+ is a form of a naturally occurring coenzyme/vitamin, and it does not appear to directly interfere with common medications or supplements based on current knowledge

For those who have undergone certain surgeries or have conditions affecting B12 absorption, more frequent injections may be necessary initially, followed by a tailored maintenance plan

So the interesting thing is doctors or physicians can start off very slowly with this process

PMID 29318504

On the other hand, with ligation of the inferior caval vein occlusion we made a recapitulation of Virchow

Some groups are more likely to struggle with absorption or not get enough B12 from food alone