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When NNMT is overactive in adipocytes, SAM is depleted reducing the cells capacity for methylation reactions that regulate gene expression, including the epigenetic programs that control energy expenditure

Maintaining optimal levels of these vitamins is particularly important during weight management or when undergoing medical treatments like semaglutide therapy, which can impact nutrient absorption

First level laboratory assessment should include vitamins B12 and folate serum and pyridoxine levels if possible