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Our providers at Family Health Care can help by evaluating your symptoms and running appropriate tests, including checking your vitamin B12 levels

While this methylation reaction was historically considered a relatively minor metabolic pathway for nicotinamide clearance, research over the past decade has revealed that NNMT plays a surprisingly important and previously underappreciated role in cellular energy metabolism, NAD+ homeostasis, adipocyte biology, and whole-body metabolic regulation
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Discussion In this randomized, blinded clinical trial of vitamin B-12 supplementation during pregnancy and early lactation, we found that urban south Indian women responded with higher plasma and breast milk concentrations of vitamin B-12

To sum up, some patients report the worsening of symptoms within the first few days or weeks when they begin B12 shots