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Importantly, persistently high serum B12 in the absence of supplementation should prompt GP assessment, as it may indicate underlying disease processes

She is a practicing physician at Root Functional

At the molecular level, 5-amino-1MQ functions as a competitive inhibitor of NNMT, demonstrating remarkable potency with an IC of 1.2 0.1 M under standard assay conditions (50 M SAM, 100 M nicotinic acid). This represents a dramatic 10-fold improvement over the parent compound 1-methylquinolinium, achieved through strategic amino group substitution that enhances binding affinity to the NNMT active site. The compound's mechanism centers on preventing the methylation of nicotinamide to 1-methylnicotinamide (1-MNA), thereby preserving nicotinamide for recycling back to NAD+ through the salvage pathway. This intervention effectively blocks what researchers have termed the "NNMT metabolic drain" a process that simultaneously depletes NAD+ precursors and consumes cellular methylation capacity

Vitamin B12: another water-soluble vitamin that is easily absorbed by the body and plays a role in metabolism processes [3]

However, it is common for older people to have some level of B12 deficiency