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As we age, NAD+ levels decline, leading to fatigue, brain fog, and slower recovery

Factors Requiring Dosage Modifications Several factors might need a change in B12 injection dosage

In summary, the key interactions to consider are pyridoxines reduction of levodopa and anticonvulsant efficacy, niacinamides additive effects on blood pressure, blood sugar, and gout management, and the potential need for B-vitamin repletion in patients on certain medications (diuretics, isoniazid, etc.)

If necessary, you may be referred to another specialist within the NHS, such as a haematologist, gastroenterologist, or dietician

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