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This is actually one of the more common causes of high vitamin B12 levels

Enhanced Metabolism B12 supports metabolic function

These adjustments could involve prescribing alternative GLP-1 medications, customized dosing and formulations, and working collaboratively on a personalized treatment plan, in combination with diet, lifestyle, and fitness activities

It improves estrogen ratio in the body

Notes that alternative pathways such as polyamine biosynthesis could compensate for raised SAM, that partial rather than total inhibition may be preferable to avoid compensatory mechanisms from an imbalanced SAM/SAH ratio, and that the consequences of sustained NNMT inhibition on systemic epigenetics remain unclear