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This is possible because these medications act through different mechanisms

The mitochondrial machinery that burns fat depends on B vitamin cofactors

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At the molecular level, reduced NNMT activity shifts cellular methylation patterns, potentially altering epigenetic modifications via changes in SAM/S-adenosylhomocysteine (SAH) ratios

In obese rodent models, it promotes lipolysis by breaking down stored fats into free fatty acids without stimulating GH pathways such as IGF-1