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Human data is still limited, so results vary and it's used under supervision

More importantly, many people have underlying issues that block B12 absorption, regardless of what they eat

You might get them weekly at first and then less often

In states of obesity and aging, NNMT is often overexpressed, leading to the excessive methylation and excretion of nicotinamide

23, Rome: Food and Agriculture Organization of the United Nations

Some research from Germany has shown that an even higher threshold (over 500 pg/mL) is necessary in early-to-mid pregnancy to maintain vitamin B12 levels throughout pregnancy, lactation, and to support an infants vitamin B12 status (via breast milk) through 6 months of age