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This enzymatic action depletes the available intracellular pool of nicotinamide, directly limiting the synthesis of nicotinamide adenine dinucleotide (NAD+)

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Age-related considerations Clinical trials included adults across a range of ages, but specific data on elderly populations is limited

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20 Systematic reviews: Oral vitamin B 12 replacement for the treatment of pernicious anemia 21 Relevant articles were identified by PubMed search from January 1, 1980 to March 31, 2016, focusing on patients with pernicious anemia