"Elevated methylmalonic acid is related to cognitive impairement in older adults enrolled in an elderly nutrition program"
These include peripheral neuropathy (tingling, numbness, or burning sensations in the hands and feet), difficulty walking, balance problems, and memory impairment

INTRODUCTION Obesity is a major public health problem around the world that is linked to severe comorbid disease conditions, physical impairment, high mortality rates, and compromised quality of life.[14] Obesity is characterized by the buildup of excessive body fat and extreme dysregulation in whole-body energy expenditure, glucose, hormone, and lipid homeostasis that typically present as adverse metabolic disorders.[4, 5] Additionally, the physiological, metabolic, and psychological changes that accompany obesity are major factors in the development of type 2 diabetes (T2D), cardiovascular disease (CVD) (e.g., coronary heart disease, dyslipidemia, hypertension),[6, 7] stroke, inflammation, non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), osteoarthritis, sleep apnea, and several obesity-linked cancers (e.g., colorectal, breast, kidney, prostate).[6, 8] Lifestyle modifications including diet and exercise may help reverse obesity and improve chronic disease biomarkers (e.g., T2D),[9] but are largely ineffective in achieving sustained weight loss and glycemic control.[10] Pharmacological treatments for obesity exist, but unfortunately most approved anti-obesity drugs have only modest efficacy and/or produce severe adverse effects (e.g., cardiovascular risks, central nervous system effects)

Apply light pressure with an alcohol pad after withdrawal if any bleeding occurs
Injecting or infusing NAD+ directly is different from taking a precursor like NR or NMN, and the pharmacokinetics of a large NAD+ dose are still debated
This keeps B12 levels just right