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By inhibiting NNMT, 5-Amino-1MQ increases cellular SAM and NAD+ levels, enhances NAD+ salvage pathway flux, activates SIRT-1, boosts oxidative phosphorylation (OXPHOS), and influences cellular energy homeostasis and epigenetic modifications

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In patients with Leber's disease, administration of cyanocobalamin may cause acute and rapid atrophy of the optic nerve