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They are referred to as vitamers having vitamin activity as a coenzyme, meaning that its presence is required for some enzyme-catalyzed reactions
Buffered NAD+ ships with a pH stabilizer (most commonly Tris) that brings the reconstituted solution closer to physiological pH (~7-8.5), while unbuffered NAD+ reconstitutes acidic (~pH 3-4) and is more often associated with injection-site stinging
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If severe B12 deficiency with neurological involvement is suspected, treatment should be initiated promptly without waiting for test results, and specialist advice may be needed
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