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Published 2018 Sep 21
What we know today comes from two sources: controlled clinical trials (STEP, SELECT, SURMOUNT) and the collective experience of over 1.5 million Americans using these medications as of January 2026
If you have certain digestive disorders, including pernicious anemia, or have had gastric bypass surgery, oral B12 will simply not work because you can't absorb it correctly
NNMT inhibition reduces one methylation pathway, but it doesn't directly deplete systemic methyl donorsit redirects nicotinamide away from methylation toward NAD+ salvage
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