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This preclinical study demonstrates that vitamin B12 supports mitochondrial metabolism through altering gene expression and multiple metabolic pathways

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At the same time, more of your existing NAD+ gets consumed by enzymes like CD38 and PARPs, which are activated by things like inflammation, oxidative stress, and DNA damage

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In cases of documented vitamin deficiency, the regimen could be an initial intensive phase (like 2 mL IM three times a week for 2 weeks) followed by reevaluation