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I use high-quality Hydroxocobalamin or Methylcobalamin depending on your needs delivered intramuscularly for fast absorption

Several factors can contribute to the development of piles: The most common cause is straining during a bowel movement, usually because of constipation

In D-galactose-induced aging mice, oral administration of the product significantly increased NAD+ levels in liver and adipose tissue, activated mitochondrial energy metabolism pathways, improved insulin sensitivity, lowered blood glucose and lipid levels, reduced visceral fat accumulation, and increased energy expenditure, alleviating fatigue and abnormal body weight associated with aging

Hormone replacement gives you synthetic hormones directly

And the creams and serums you have tried