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These symptoms develop gradually because the body stores several years worth of B12 in the liver, meaning deficiency takes time to become clinically apparent

(4) Blood Pressure (3) In blood pressure studies, compared with l-arginine, pentadecapeptide BPC 157 (without effect on basal normal values) had both a mimicking effect (impaired l-NAME-blood pressure increase, when applied prophylactically and decreased already raised l-NAME values, given at the time of the maximal l-NAME-blood pressure increase (i.e., 10 min after l-NAME)) and preventive activity (l-arginine-induced moderate blood pressure decrease was prevented by BPC 157 pretreatment)

doi: 10.1002/dneu.22187

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It uses a methyl group donated by S-adenosylmethionine (SAM) to methylate nicotinamide a vitamin B3 form that would otherwise be recycled back into NAD+