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B12 deficiency can still occur in banded patients but it is usually related to reduced food intake rather than a structural absorption problem

There are a handful of small human case reports, but no proper clinical trials

By treating metabolically active adipocytes and hepatocytes with 5-amino-1-methylquinolinium, researchers can precisely inhibit intracellular NNMT activity, monitor changes in the nicotinamide pathway and NAD+ levels, and analyze effects on energy metabolism

Nutritional optimization instead of supplementation Focusing on b12-rich foods may provide adequate amounts for many patients

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