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Because SAM is also required for many other methylation reactions, including gene-expression regulation, high NNMT activity draws heavily on SAM and is associated in studies with reduced NAD, a coenzyme central to cellular energy production

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Loading phase (deficiency): 1000 mcg IM or subQ daily or every other day for 1 to 2 weeks Maintenance: 1000 mcg monthly is a standard maintenance dose for conditions like pernicious anemia Wellness protocols: may use lower doses weekly, though this is less established clinically In ml: cyanocobalamin is typically supplied at 1000 mcg/ml, so a 1000 mcg dose equals 1 ml

& Salzberg, S

(85 g) provides 93% of the DV (22,27)