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Regarding FDA approval: because this is a compounded product, it is not directly FDA-approved

Its activity intersects two major metabolic pathways simultaneously: the NAD+ biosynthesis pathway (by consuming nicotinamide, an NAD+ precursor, NNMT competes with the NAD+ salvage pathway) and the methyl-donor pathway (by consuming SAM, NNMT reduces the availability of methyl groups for epigenetic and metabolic methylation reactions)

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These interactions can influence biological functions without the full range of effects that HGH might cause, such as impacting insulin sensitivity or growth-related effects on bones and organs

However, the bioavailability of the B12 injection depends on the form used