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One of the most common things I look for when I see unexplained high B12 with concurrent symptoms is mast cell activation syndrome (MCAS)
Outstanding purity & consistency
Another example: individuals with chronic alcoholism often need prolonged thiamine/B-complex support
NNMT is expressed in some cancer cells, which makes interpretation of inhibition complex: effects could differ by cancer type or stage, and the data are largely from models rather than long-term human study
A deficiency in B12 can lead to neurological problems, including nerve pain
It might change based on how well you respond to treatment and your specific needs
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