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If needed for a clear medical indication (such as treating pellagra in a pregnant patient), niacinamide can be used with caution, but unnecessary high-dose B supplementation is avoided in pregnancy

It influences energy metabolism by improving glucose homeostasis and insulin sensitivity and enhances glucose uptake and utilization in cells which leads to improved energy metabolism

A plan tailored by doctors

We might change the dose if: Patients dont get better or keep having symptoms of deficiency They keep having trouble absorbing nutrients Their health changes or they get new health problems By watching both lab results and how patients feel, we can make Vitamin B12 shots work best for them