Published rodent and cell-culture work has examined NNMT inhibition in the context of adipocyte metabolism and of methyl-donor and NAD pool dynamics
Most patients schedule their next shot before the previous one fully wears off to keep B12 levels steady
According to the NIH Office of Dietary Supplements, functional B12 deficiency is most commonly seen in patients with one or more of the following: Age over 50 stomach acid production declines with age, and stomach acid is required to free B12 from food PPI or H2 blocker use reflux medications suppress the acid needed for B12 absorption Metformin use, which interferes with B12 absorption directly Vegan or vegetarian diets B12 is found almost exclusively in animal products Gut conditions including celiac, IBS, SIBO, and Crohns MTHFR mutations that affect how B12 is metabolized once absorbed Heavy alcohol use The symptoms of low B12 are easy to dismiss: fatigue, brain fog, low mood, tingling in the hands or feet, weakness, and shortness of breath on mild exertion
Research interest in multi-pathway incretin compounds has expanded significantly in recent years as scientists work to map how these receptors interact
Maintenance is usually monthly, though some people do better on a biweekly schedule