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At the same time, the number of senescent cells, associated with damage or stress that secretes proinflammatory factors (SASP or senescence-associated secretory phenotype), increases with age in many key tissues, including the kidneys, lungs, blood vessels, and brain SAM may not get the same level of media attention as NAD+, but that doesnt stop it from being less useful: S-adenosylmethionine, or SAM, has been used for several years in the treatment of hepatic conditions and osteoarthritis and more recently in the treatment of clinical depression

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Intramuscular (IM) B12 injections using hydroxocobalamin, the preferred licensed form in the UK are recommended when: Oral supplementation has failed to correct a documented deficiency The patient has difficulty adhering to daily oral regimens Serum B12 levels remain persistently low despite adequate oral dosing There is clinical evidence of neurological or haematological complications In line with BNF guidance, the standard IM regimen for confirmed deficiency without neurological involvement is a loading course of 1 mg hydroxocobalamin on alternate days for two weeks , followed by maintenance of 1 mg every three months

This may, in part, be mitigated by proper storage of these medications including the use of a suitable, safe delivery point for home delivery of medications