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The researchers termed this "chronic cytoprotection." The cell-protection effect did not diminish with extended use

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However, it is noteworthy that knockdown of NNMT does not seem to affect NAD + levels in the liver, indicating potential divergent regulatory mechanisms of NNMT in these tissues and suggesting the existence of redundant pathways in NAD + metabolism regulation (Trammell and Brenner, 2015)

In summary, the reasons a GP surgery may refuse an early B12 injection are often rooted in a strict interpretation of established, but imperfect, guidelines, a misunderstanding of the actual science of B12 storage and metabolism, and a desire to maintain administrative consistency