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People with symptoms of vitamin B12 deficiency It is a good idea for anyone with the following signs and symptoms of a vitamin B12 deficiency or pernicious anemia to consult a doctor: People with gastrointestinal issues Conditions that affect the gastrointestinal tract may affect vitamin B12 release or absorption, including: pernicious anemia, which can lead to gastric atrophy, or damage to the stomach fish tapeworm infestation bowel or pancreatic cancer folic acid deficiency overgrowth of bacteria in the small intestine diabetes thyroid disease Crohns disease celiac disease chronic pancreatitis People who have undergone gastrointestinal surgery, including weight loss, may have fewer cells necessary to secrete stomach acid and intrinsic factor

Peter Attia, a longevity physician, discusses NAD+ precursors: "While evidence is emerging, NAD+ boosting shows promise for mitochondrial health and longevity, though IV might not be optimalprecursors like NMN could be better."[33][20] On combinations, he cautions on long-term data but notes potential for metabolic disorders

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do not use it once expired

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. Doctors may not be prescribing oral vitamin B12 formulations because they may be unaware of this option or have concerns regarding its effectiveness Objectives: To assess the effects of oral vitamin B 12 versus intramuscular vitamin B 12 for vitamin B 12 deficiency. Selection criteria: Randomized controlled trials (RCTs) comparing the effect of oral versus IM vitamin B 12 for vitamin B 12 deficiency