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In pernicious anaemia, there is a very high risk of worsening or recurrence of symptoms when B12 injections are stopped, and even when people are forced to switch to oral supplementation

doi: 10.1245/s10434-011-1764-6

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NCT06376591)

If inhibiting NAD+ synthesis has an adverse effect on 5-amino-1MQs muscle-enhancing effects, this would show that, indeed, the compound likely works through increasing NAD+ levels