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Some patients receiving Vitamin B12 injections report feeling worse after their treatment, an unexpected reaction considering these injections are typically used to alleviate symptoms of B12 deficiency

It covalently and selectively binds to endogenous albumin post-injection

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When NNMT is overactive, it consumes S-adenosylmethionine (SAM) and reduces levels of nicotinamide adenine dinucleotide (NAD+), a critical coenzyme involved in cellular energy production

This does not change the reconstitution process, but it does mean the side effect profiles during dose escalation can differ