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The reduced enzymatic activity increases cellular concentrations of both substrates that NNMT would otherwise consume: S-adenosyl-L-methionine (the universal cellular methyl donor) and nicotinamide (the NAD + salvage precursor)

Absent intrinsic factor is often associated with a condition called atrophic gastritis, a thinning of the lining of the stomach

Many online sources are unregulated, and purity, dosing, sterility, and contamination are real risks

However, MMA levels can be elevated in those with thyroid and kidney conditions, which limits the tests specificity (9, 10)

Someone once described it to me as the nerves starting to wake up after being starved of B12 for so long