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Any such adverse reaction should be evaluated by a healthcare provider

Healthcare providers must keep a close eye on patients getting high-dose B12 therapy to handle any side effects well

NNMT inhibition reduces one methylation pathway, but it doesn't directly deplete systemic methyl donorsit redirects nicotinamide away from methylation toward NAD+ salvage

Missed dose management requires careful consideration to maintain therapeutic efficacy while avoiding adverse effects from irregular dosing

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For example, pernicious anemia, an autoimmune disease of the stomach, can cause low B12 levels