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Pathological causes of elevated B12 warrant careful consideration: Haematological disorders : Myeloproliferative neoplasms (polycythaemia vera, chronic myeloid leukaemia), acute leukaemia, and lymphoproliferative disorders can increase B12-binding proteins (transcobalamin and haptocorrin), elevating total serum B12 [3] Liver disease : Hepatocellular damage releases stored B12 into circulation

This randomized controlled trial demonstrates that 28 days of vitamin B complex supplementation significantly improved exercise endurance and reduced fatigue-related biomarkers in healthy adults

If you are B12-deficient, your doctor will determine how much of the vitamin you need to take

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[7] Unlike lyophilized powder, the aqueous NAD+ solution cannot be stored at room temperature for extended periods, as the dissolved product is sensitive to temperature fluctuation and requires continuous refrigeration to prevent degradation