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Doctors may not be prescribing oral vitamin B 12 formulations because they may be unaware of this option or have concerns regarding its effectiveness

However, in human systems the outcome of boosting NAD+ is complex and likely involves numerous pathways, from enhanced activity of sirtuins (implicated in longevity and metabolic control) to improved DNA damage repair, all of which are areas of ongoing investigation

To put it in context, nicotinamide has shown signs of liver toxicity only at doses around 3,000 mg per day or higher

The physician was not rebuked because the patient was treated according to guidelines

DGAT inhibitors for obesity

If you experience unexpected symptoms whilst taking B12, discuss with your GP whether continued supplementation is necessary or whether dose adjustment might help