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NAD+ supports fundamental energy pathways in all cells, including cancer cells, raising concern that artificially boosting NAD+ might fuel malignancy growth or interfere with certain cancer treatments

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Conclusion Whilst severe B12 deficiency has a clear clinical picture with characteristic haematological and/or neurological features, establishing mild or borderline deficiency can be problematic as serum levels are maintained at the expense of tissue concentrations, and therefore serum levels of B12 may be in the low normal or borderline range despite a deficiency

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