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Strategies for manipulating the microbiota include the use of prebiotics, administration of probiotics, fecal microbiota transplantation (FMT) for bacterial recolonization, and antimicrobial treatments to eliminate harmful pathogens or optimize specific bacterial populations

Because SAM is also required for many other methylation reactions, including gene-expression regulation, high NNMT activity draws heavily on SAM and is associated in studies with reduced NAD, a coenzyme central to cellular energy production

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