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However, if these vasodilators enter the systemic circulation, they could contribute to ME/CFS symptoms such as fatigue, flu-like symptoms, pain, fever, and sleep disturbances, similar to the effects observed when vasodilators spill over in dysmenorrhea (346)

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For patients pairing B12 with NAD+ IV therapy during energy-focused protocols, B12 typically runs weekly between NAD+ sessions and helps sustain the cellular energy benefits between infusions