You might benefit from a B12 shot if you: Follow a vegan or vegetarian diet
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I was convinced it came about after a very stressful period in my life I do still drink and probably too much but I also exercise a lot so I self inject weekly and that seems to work for me
S.BazmaniA.SadeghsoltaniF.Saghaei BagheriH.et al (2023)
In most of the diseases NAD + was strongly positively associated with NADH and NADP+, which is in line with known role of NAD + as substrate for NADH and NADP+ synthesis