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Megaloblastic anemia Diminished activity of methionine synthase in vitamin B 12 deficiency inhibits the regeneration of tetrahydrofolate (THF) and traps folate in a form that is not usable by the body ( Figure 3 ), resulting in symptoms of folate deficiency even in the presence of adequate folate

(7) This stage may go on for decades before enough damage is done, and before one can detect a change in thyroid hormone levels on a blood test at this stage, the TSH, Free T3, and Free T4 levels will be normal

Epigenetic and Cellular Reprogramming: By blocking NNMT-mediated methylation of nicotinamide, preserves NAD salvage pathway activity, increases SIRT-1 signaling, reduces histone deacetylation, and promotes metabolic reprogramming toward oxidative phosphorylation and glycolysis balance, supporting tissue repair and energy homeostasis 1-4

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