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These include vitamin B12 deficiency and malabsorption that is caused by the following medical conditions, according to the NIH [1]: Pernicious anemia Tropical sprue Pancreatic insufficiency Surgery in the gastrointestinal tract Certain medications Deficiency in the diet Side effects of B-12 injections Also, according to the NIH, vitamin B-12 injections have some potential side effects, including [1]: Diarrhea Itching Swelling Risk of allergic reaction and anaphylaxis Can Vitamins Aid in Weight Loss

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Levonen AL, Lapatto R, Saksela M, Raivio KO

Research in animal models indicates that NAD + metabolism is severely compromised during AD progression

the participants were taking the supplement, but their bodies weren't actually "getting" it