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It is measurable

In fact, its considered the gold-standard solution for relieving hot flashes, night sweats, vaginal dryness, and the genitourinary syndrome of menopause (GSM), according to the North American Menopause Society

Available at: (accessed April 2, 2024)

As shown in the Figure above, at the end of a month, weekly nasal administration results in significantly higher serum vitamin B12 levels than after intramuscular administration

Some researchers have conceptually explored combining both strategies for potentially synergistic effects on intracellular NAD+ levels, though no published data exists for this specific combination