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Here's what the literature says, without the community fantasies

Scientific References Diagnosis and classification of pernicious anemia

But fatigue is not simply a symptom of low NAD. It can result from: Poor sleep Sleep apnea Iron deficiency Vitamin B12 deficiency Thyroid disorders Chronic stress Inadequate calorie intake Dehydration Medication effects Depression Infection Other medical conditions That is why I would be cautious about treating unexplained fatigue with an NAD injection before understanding why the fatigue exists

- continue to regularly monitor B12 status every 3-6 months to ensure levels stabilize well within acceptable range