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As you get older, your body naturally produces less NAD+
Therefore, the first place you need to look when the benefits of a methyl-B12 shot seems to wear off too soon is to retry the shots at the same dose and frequency but make the angle of attack much more severe, much closer to the horizontal plane, just under the skin
Studies show that NNMT inhibition by 5-amino-1-methylquinolinium significantly reduces nicotinamide metabolism, increases NAM accumulation, improves NAD+ synthesis efficiency by over 30%, and markedly increases mitochondrial ATP production and cellular energy metabolism
Zero-order kinetics are a dosing nightmare
If you suspect you've experienced side effects from vitamin B12 supplementation, you can report these through the MHRA Yellow Card scheme