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I have suffered with this gradually since my early teens

We get vitamin B12 from the food we eat - it can be found in meat (esp organ meat - liver), fish, shellfish, dairy products, eggs, some fortified breakfast cereals, and fermented foods

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Sources and references Vitamin B12 - Health Professional Fact Sheet Vitamin B12 - Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline Vitamin B12 Supplementation Adequacy in Australian Vegan Study Participants - PMC Vitamin B12 (Cobalamin) - StatPearls - NCBI Bookshelf Inherited and acquired vitamin B12 deficiencies: Which administration route to choose for supplementation

Cellular NAD+ Salvage Pathways: Examining changes in intracellular Nicotinamide Adenine Dinucleotide (NAD+) pools resulting from decreased NNMT activity, and its subsequent impact on sirtuin activity and mitochondrial bioenergetics

Since its development, AOD-9604 has been the subject of over 16 peer-reviewed publications spanning three decades, including six randomized, double-blind, placebo-controlled human clinical trials involving more than 900 participants