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Because SAM is also required for many other methylation reactions, including gene-expression regulation, high NNMT activity draws heavily on SAM and is associated in studies with reduced NAD, a coenzyme central to cellular energy production

However, some observational studies have linked very high supplemental intakes of B12 with potential health risks, including increased rates of certain cancers or fractures in specific populations

Treating vitamin B 12 deficiency Treatment for this condition involves replacing the missing vitamin B 12

Not necessarilymany patients use B12 injections proactively for energy and immune support