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Because of NAs tendency to cause flushing (a warming rush of blood to the face), it may be a less-than-ideal NAD+ precursor for many potential users.8 De novo synthesis pathway Rather than B3, the de novo synthesis pathway starts with the amino acid tryptophan, which metabolizes into quinolinic acid, which in turn converts to NAMN

I do have some obvious reasons that would drive low b12, I have the snyp on my genes that stops it converting to the active form, I have hashimotos although antibodies have been rapidly decreasing since starting b12 replacement

Animal research demonstrates promising results for ulcer healing, inflammation reduction, and gut barrier repair in balanced evaluation