Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, 25 milligrams of vitamin B6 and one milligram of vitamin B12 per day for 36 months or a matching placebo
Altering substituents on the aromatic rings can significantly change binding affinity to NNMT
No trial reported on clinical signs and symptoms of vitamin B 12 deficiency, health-related quality of life, or acceptability of the treatment scheme Orally taken vitamin B 12 showed lower treatment-associated costs than intramuscular vitamin B 12 in one trial
The relevant research question is whether intracellular NNMT inhibition produces pathway-specific effects under defined laboratory conditions, or whether broader changes in nicotinamide metabolism, NAD + availability, SAM-dependent methylation balance, and related biochemical pathways may influence additional cellular systems
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