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Often, you'll have the neurological or psychological symptoms before the anemia (low red blood cell count) is present

This is why it is studied for therapeutic purposes

9 Getting a B12 Shot Earlier in the Day Will Decrease the Chance of Insomnia B12 shots do not contain any stimulants , but depending on how sensitive you are, getting the shot in the evening may lead to vivid dreams or insomnia

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Introduction Nicotinamide N -methyltransferase (NNMT) catalyzes the transfer of a methyl group from the methyl donor S -adenosyl methionine (SAM) to nicotinamide (NAM) and other pyridine related compounds, producing S -adenosyl-l-homocysteine (SAH) and N1-methylnicotinamide (1-MNA) (Fig