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When you rely on an oral B12 supplement as your main pernicious anemia medication, you are basically hoping that some of that B12 will make its way into your bloodstream even though your intrinsic factor isnt there to help

(PubMed) Stone KL, Lui LY, Christen WG, et al

It improves metabolism and oxygen transport, providing our cells with the necessary energy and nutrients, thereby relieving the cognitive and physical symptoms associated with depression

The age-related drop in NAD+ levels is caused by rising levels of CD38, a membrane-bound NADase that degrades both NAD+ and its precursor nicotinamide mononucleotide, according to a 2016 study in mice, which exhibit age-related declines in NAD+ levels similar to those seen in humans (7)

Blood cell production typically begins improving within 35 days, haemoglobin rises over 12 months, whilst neurological recovery may take several months