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Most vitamin B12 injections and oral supplements in the United States use a form of vitamin B12 called cyanocobalamin, however this form of vitamin B12 has the toxin cyanide connected to the molecule

NAD+ replenishment is cumulative

In other words, if theres any type of nerve root compression or irritation at the cervical spine or the lumbar spine, an epidural steroid injection can be performed at the inflamed or impinged area to relieve neck and upper extremity or low back and lower extremity symptoms. All these injections can also be performed to enable proper physical therapy, reduce the use of opioids and other medications, and allow function that would otherwise be impossible