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Its common to start treatment for a significant vitamin B12 deficiency with weekly intramuscular shots (1000 micrograms of vitamin B12)

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Ayabe T, Satchell DP, Pesendorfer P, Tanabe H, Wilson CL, Hagen SJ, Ouellette AJ: Activation of Paneth cell -defensins in mouse small intestine

Most published human trials have used precursors (NR or NMN) rather than direct liposomal NAD+, and have measured blood NAD+ levels rather than functional endpoints like energy, recovery, or healthspan