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As a result, a shortage of B12 in the body can have a negative impact on red blood cell production, limiting the amount of new cells produced and reducing the amount of energy available to your cells

NICE and British National Formulary (BNF) guidance recommend 1 mg hydroxocobalamin on alternate days until no further improvement in symptoms is observed

Because it modulates cellular NAD+ availability and mitochondrial function, some protocols administer it in the morning to align peak NNMT inhibition with waking metabolic activity