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Common causes include liver disease (which releases stored B12), kidney disease (reducing B12 clearance), haematological malignancies, solid tumours, and excessive supplementation

Brazilian Journal of Microbiology, 41(3): 635642 Matafonova G, Batoev V (2012)

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And with its FDA Category 2 classification, sourcing pharmaceutical-grade AOD-9604 has become increasingly difficult

Brazil nut (Bertholletia excelsa Bonpl.) in health and disease: A narrative review

Overall, NAD+ therapy has the potential to improve mental health outcomes by improving cognitive function, reducing anxiety and depression, supporting addiction recovery, improving energy and motivation, and reducing symptoms of PTSD