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NICEs guideline covers recognising and managing B12 deficiency in adults, including deficiency linked to autoimmune gastritis

B12 also contributes to a better nights sleep, as serotonin is a precursor to melatonin, the hormone responsible for regulating sleep patterns

It is separated from ingested food through the action of the gastric acid, and in the duodenum the vast majority binds to intrinsic factor (IF)

Aging reduces NAD+ synthesis pathways while increasing consumption by enzymes like CD38 and PARPs, activated by inflammation and damage.[13][15] CD38, an immune-related enzyme, ramps up with age, breaking down NAD+ precursors

It typically begins with declining blood levels (stage I), followed by low cellular levels (stage II), increased homocysteine levels and reduced DNA synthesis (stage III), and finally macrocytic anemia (stage IV)