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Megadoses of B12 can lead to headaches, nausea, diarrhea, vomiting, and flushing, he says

a NNMT inhibitor such as a cation of Formula I or IA, or otherwise disclosed herein one or more chemical entities e.g., nicotinamide riboside, nicotinamide mononucleotide one or more NNMT inhibitors (such as a cation of Formula I or IA, or otherwise disclosed herein) is contacted with a cell expressing NNMT concurrently with one or more chemical entities (e.g., nicotinamide riboside, nicotinamide mononucleotide) that increase intracellular NAD+ levels to provide muscular therapy

Cytoprotective Mechanisms Seiwerth et al

While some multivitamins contain vitamin B12, they often dont provide enough to treat a deficiency