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Note that spending totals are estimates generated by comparing previous government data figures from Medicaids State Drug Utilization Database to real-time claims data

If a person has a liver disorder, for example liver disease, then the liver is unable to store vitamin B12 and this can lead to a B12 deficiency

NNMT depletes the NAD+ precursor pool by methylating nicotinamide the same nicotinamide that the salvage pathway would otherwise convert back into NAD+ via the enzyme NAMPT

PMID 18656819

If the patient is suspected to be sensitive to cobalt or other components of cobalamin, an intradermal test dose is recommended (10, 13)