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While this methylation reaction was historically considered a relatively minor metabolic pathway for nicotinamide clearance, research over the past decade has revealed that NNMT plays a surprisingly important and previously underappreciated role in cellular energy metabolism, NAD+ homeostasis, adipocyte biology, and whole-body metabolic regulation

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The liver stores B12, and these stores can last a significant time (up to several years for non-deficient individuals), but when they are depleted, it takes consistent input to rebuild and maintain them