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As a refresher, NAD + shuttles electrons into the mitochondria to generate energy

Absorption problems Even with adequate intake, absorption can be reduced by: Certain gastrointestinal conditions affecting the stomach or small intestine Some medications Age-related reduction in stomach acid (which can affect absorption) Autoimmune gastritis (often historically referred to as pernicious anaemia) This is a well-recognised cause of B12 deficiency and may require ongoing management

Minerals such as copper, cobalt, selenium, iron, manganese and molybdenum compete with each other for metabolically important processes in the animal

A person with borderline deficiency will certainly reach the ideal level faster than someone with pernicious anemia or severe malabsorption