Additionally, any potential for toxicity must be taken into account when choosing a bacteriostatic agent
Many successful outcomes involve gradual rather than dramatic initial changes
It can be prescribed by a licensed practitioner and compounded by a 503A pharmacy for individual patients, though the regulatory landscape has been evolving

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Clinicians may monitor complete blood counts, vitamin B12 levels, methylmalonic acid, homocysteine, potassium, or other markers depending on the situation
Research shows this small molecule is an inhibitor of nicotinamide N-methyltransferase (NNMT), an enzyme involved in cellular energy regulation and fat metabolism