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Rather than directly supplying NAD+ precursors (like NMN or NR), it works by blocking an enzyme that consumes nicotinamide, theoretically preserving the substrate pool for endogenous NAD+ production

[DOI] [PMC free article] [PubMed] [Google Scholar] 47.Okamura M, Inagaki T, Tanaka T, Sakai J

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The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42024554513 (Available from) ( 2.2 PICOs question The primary research question addressed in this review was: What is the effectiveness of sublingual/oral administration of Vitamin B12 alone or compared to other forms of administration (e.g., intramuscular injection)?

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Severe Anemia Risks: In people with severe megaloblastic anemia, aggressive treatment can cause low potassium (hypokalemia) and sudden, serious complications