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This reaction effectively diverts nicotinamide away from the NAD+ salvage pathway, reducing the cell's capacity to regenerate NAD+

Neurological recovery may take 612 months, and some deficits may be permanent if treatment is delayed

Add the fourth that almost nobody mentions riboflavin (25-50mg)

And when there are symptomsthings like fatigue, tingling hands, and feet, dizziness, and memory losstheyre often so non-specific that doctors wont always flag B12 deficiency as an obvious cause

human efficacy is unproven and individual results vary

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