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Therefore, the aim of this study was twofold: 1) to assess vitamin B12 serum levels in ME/CFS patients before and after use of high dose vitamin B12 nasal drops and 2) to compare the changes in function before and after starting therapy, using an activity meter, the physical functioning score of the Rand 36 questionnaire, and both the fatigue and concentration scales of CIS20r questionnaire
Elevated NAD+ levels activate sirtuins, particularly SIRT1, which are NAD+-dependent deacetylases that regulate numerous metabolic processes including fat oxidation, glucose metabolism, mitochondrial biogenesis, and cellular stress responses
According to NICE Clinical Knowledge Summaries, once B12 deficiency is adequately treated and symptoms resolve, routine monitoring of serum B12 levels is generally unnecessary, as clinical response is the primary indicator of treatment effectiveness
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