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Fatigue/low energy Weakness Numbness and tingling in the hands and feet Cognitive impairment (most commonly seen in the elderly population) A significant deficiency can cause nerve damage The complicated absorption of vitamin B12 B12 is bound to protein in food and must be released in the stomach with the help of HCL (stomach acid) and pepsin

(Source) The Delivery Argument Breckas position is that most NAD supplements dont work because standard oral NAD+ breaks down in the stomach before it ever reaches cells, wasted time and money as he puts it

10.1046/J.1471-4159.1997.69031196.X 11 Allan ButterfieldD.Boyd-KimballD

Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial Lau DCW, Erichsen L, Francisco-Ziller N, et al

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This creates a substantial energy deficit that drives overall fat loss