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When you dont have enough NAD+, your brain is unable to convert sufficient amounts of glucose into energy, which leaves your brain cells supply of cellular energy depleted

This hypothetical adverse effect, although not clinically reported until now, is analogous to the hypothalamic-pituitary axis suppression seen with long-term use of systemic corticosteroids Exacerbation of Helicobacter pylori associated peptic ulcers: Helicobacter pylori is known to feed on macrophages and neutrophils abundant at the site of inflammation caused by the ulcer

however, in the case of injury or disease, loss of NMNAT activity leads to NAD + depletion and NMN accumulation, which in turn activates SARM1 53,54,289

There are various reasons for a vitamin B12 deficiency, but most of them relate to an intestine absorption of the vitamin

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What does an injection do that an oral supplement doesnt