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Maintenance therapy requires lifelong injections every two to three months to prevent relapse of deficiency
When a cell over-expresses NNMT, it does two costly things at once: it burns through methyl-donor capacity, and it diverts nicotinamide away from NAD+ regeneration into an inert metabolite (1-methylnicotinamide) that gets excreted
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Remarkably, these results happened without changes in food intake
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