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Additionally, NAD + is required for fatty acid metabolism during -oxidation, glutaminolysis generating -ketoglutarate, mitochondrial shuttling of metabolites, and lactic acid fermentation 35

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In this answer 3 sections The reason you started with intense every other day B12 shots and transitioned to a monthly schedule is a medical strategy called loading and maintenance. When you were first diagnosed, your bodys B12 stores were dangerously low

I'm also having itchy skin and small break outs of pimples from b12 injections

PMID: 25756278 This page explains vitamin B12 injection schedules for educational purposes only