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Our observation that intracellular NA concentrations did not increase following NNMT inhibition extends previous studies that showed NA concentrations were largely unaffected following NNMT knockdown with either adenovirus[39] or anti-sense oligonucleotides (ASOs).[12] It is possible that significant accumulation of NA in adipocytes (and other tissues) is prevented by rapid conversion of NA to NMN and subsequent NAD + synthesis or transport to the extracellular environment.[27] Importantly, NNMT inhibition potentiated the absolute intracellular concentrations of NAD + and SAM, without altering the levels of NA and SAH in the adipocytes

These concerns can have many causes, so provider evaluation is important

Yes, you can give yourself Vitamin B12 shots

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Multidisciplinary management of acromegaly: a consensus

Cyanocobalamin Pharmacokinetics European Journal of Cardiovascular Medicine: Vitamin B12 Deficiency in Long-Term Metformin Users USFDA Adverse Event Reporting System: Vitamin B12 Deficiency Associated with Metformin and PPIs MedRxiv (PNAS Preprint): Patient-Reported Treatment Outcomes in ME/CFS and Long COVID Journal of Neurological Sciences / Nutrients: Cognitive Function and Neuropathy