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Signs and symptoms: Many common symptoms can be caused by vitamin B12 deficiency, including weakness, tiredness, lightheadedness, heart palpitations, shortness of breath, pallor (pale skin), diarrhea, decreased appetite, nerve problems like numbness or tingling, visual changes and psycho-emotional problems like depression, memory loss or behavioral changes

Improved Insulin Sensitivity and Glucose Metabolism When NAD levels rise and fat mass drops, cells become more responsive to insulin

Pregnancy and breastfeeding are also contraindications due to insufficient safety data

This combination addresses a practical limitation of semaglutide therapy