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Theres an initial inflammatory phase, a proliferative phase (new cells and blood vessels form), and a remodeling phase (the tissue reorganizes to something like its original state)

Some patients have described feelings of fatigue, body aches, or a sense of mental haze before they start noticing the improvements

Evidence-based : Ensuring clinicians understand the difference between serum B12 levels and clinically active B12 stores, and other suitable tests to determine deficiency as well as symptom resolution with sufficiently frequent treatment

NNMT (Nicotinamide N-Methyltransferase) is a cytosolic enzyme that catalyses the transfer of a methyl group from S-adenosyl-L-methionine (SAM) to nicotinamide producing 1-methylnicotinamide (1-MNA) and S-adenosyl-homocysteine (SAH) as reaction products

As damage accumulates with age and NAD+ falls, repair capacity is compromised (Fang et al., 2017)