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This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation

It says it will remove products from the market if they claim to treat or change how the body works if they are not licensed under the Human Medicines Regulations Act 2012, and that it strongly advises against purchasing and using unauthorised medicinal products - "particularly those promoted on social media".

A protein-based cGAS-STING nanoagonist enhances T cell-mediated anti-tumor immune responses

Reputable clinics typically administer NAD+ slowly over several hours to minimise these effects

Blood pressure medications could interact with it too

Therefore, early diagnosis of vitamin B12 deficiency is essential