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My advice would be keep on top of your medication, have a healthy lifestyle, try to understand your condition and make the most of the expertise, care and help available from your healthcare professionals

The competition between NA methylation and NAD + salvage indicates that NNMT might limit fuel oxidation and promote fat storage because NAD + is necessary for fuel oxidation [16]

Some patients may require an even higher dose of 2 mg weekly for optimal effect, particularly for weight management indications, though this should be approached cautiously with careful monitoring for adverse effects

A 2025 JAMA Neurology trial (n=1,500) demonstrated a 15-20% reduction in Hamilton Depression Rating Scale (HDRS) scores in deficient adults (serum B12 200 pg/mL and methylmalonic acid (MMA) 0.4 mol/L), with higher doses compensating for poor absorption or severe symptoms like megaloblastic anemia and neuropathy