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Nicotinamide is the precursor for NAD+ salvage the recycling pathway that regenerates NAD+ from the nicotinamide produced by sirtuin and other NAD+-consuming reactions

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A deficiency of Vitamin B12 can lead to advanced anemia where the red cells are fewer in number but are larger than normal (macrocytic)

A mild deficiency may not cause any symptoms

However, Vitamin B12 is not always adequately absorbed by the body in the digestion process, thus creating a deficiency