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The increase in NNMT expression can potentially spur tumor progression, while methylnicotinamide can lead to mitochondrial dysfunction, which is implicated in the pathogenesis of insulin resistance, coronary artery disease, and Parkinsons.14 15 Molecules called methyl groups can prevent this woeful accumulation by shuttling leftover NAM back into the salvage pathway, as well as by converting excess NAM to excretable meNAM, but your pool of methyl groups is limited and can quickly become depleted