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Some patients may also have underlying female pattern hair loss, PMOS, thyroid disease, low ferritin or autoimmune hair loss that becomes more apparent during weight loss

Rare hypersensitivity reactions to B12 preparations can occur, which might include systemic symptoms, though joint pain specifically is not typically reported

The metabolism and elimination of NAD+ (and its by-products) could be altered in advanced hepatic or renal dysfunction, and high-dose NAD+ might theoretically affect cardiovascular dynamics, so practitioners generally avoid or closely supervise NAD+ use in such settings

It can take a few weeks to a month to notice the effects of B12 shots, since your body has to replenish your stores of this vitamin