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These studies suggest that strategies combining NAD + boosting with inhibitors of NAD + -consuming enzymes could be a promising approach to mitigate axon degeneration

Fatigue/low energy Weakness Numbness and tingling in the hands and feet Cognitive impairment (most commonly seen in the elderly population) A significant deficiency can cause nerve damage The complicated absorption of vitamin B12 B12 is bound to protein in food and must be released in the stomach with the help of HCL (stomach acid) and pepsin

So a lack of effect after the first treatment does not mean that the treatment is not working

Among the 226 patients who received cisplatin with pemetrexed, 74% received full supplementation with folic acid and vitamin B 12 during study therapy, 14% were never supplemented, and 12% were partially supplemented