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This connection has led researchers to focus on better understanding the effect of low vitamin B12 on obesity, insulin resistance, type 2 diabetes, and cardiovascular disease

Mechanistically, NNMT suppression increased adipose SAM and NAD, upregulated polyamine flux enzymes (ODC, SSAT), and altered histone methylation consistent with a shift toward oxidative metabolism [2]

It also enhances ease of administration and maintains patient comfort

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While higher doses (particularly 54 mg) showed some increase in gastrointestinal-related events, these remained mild to moderate in severity and did not result in treatment discontinuation

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