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This helps them decide if you need B12 shots and how much

An enzyme called NNMT (nicotinamide N-methyltransferase) drains the NAD+ salvage pathway by methylating nicotinamide, one of NAD+'s precursors

They also look at your symptoms and how you respond to treatment

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This product is intended for use by qualified researchers, laboratories, and research institutions conducting in vitro or analytical studies

Cyanocobalamin is indicated for Vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacterial overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see Drug/Laboratory Test Interactions), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue