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What Are the Long-Term Risks of Cortisone Injections

Folate deficiency can present with similar macrocytosis and should be assessed concurrently

Homocysteine, vitamin B12 and folate levels in Iranian patients with Multiple Sclerosis: A case control study

Elevated NAD+ levels activate sirtuins, particularly SIRT1, which are NAD+-dependent deacetylases that regulate numerous metabolic processes including fat oxidation, glucose metabolism, mitochondrial biogenesis, and cellular stress responses

Persistently high levels warrant medical investigation to identify any underlying cause

But if it's due to pernicious anemia, your doctor will need to inject you with vitamin B12.