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In the case of pronounced absorption disorders, for example as a result of gastritis or after removal of the small intestine, in Crohn's disease, diverticulosis and the so-called blind-loop syndrome, there is a gradual decrease in the vitamin B12 store in the liver, which can turn into a manifest vitamin B12 deficiency

PMID 9655823

(Most responsible clinics have an off-ramp, not endless cycling) How do you protect lean mass

10.1016/j.fertnstert.2014.02.002 44 RasmussenJ

These options are good for people who dont like shots or need something different

By blocking NNMT, 5-Amino-1MQ prevents nicotinamide methylation, allowing NAD+ levels to rise and methyl groups to remain available for histone methylation and other epigenetic processes