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The upregulation of hepcidin inhibits the function of ferroportin, leading to intracellular iron accumulation (58), an increase in intracellular free iron levels, and subsequent lipid peroxidation and ferroptosis (59)

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In vitro experiments and animal studies generally evaluate how NNMT inhibition alters metabolite levels, cellular redox balance, and gene expression patterns associated with energy regulation

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Unexplained fatigue despite adequate rest, decreased training capacity without apparent cause, or slow recovery between sessions all warrant investigating your B12 status