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This is local discomfort, not a sign the treatment has gone wrong

Hoefnagels, Wija A

By reducing SAM consumption through NNMT inhibition, 5-Amino-1MQ helps preserve methylation capacity for other critical cellular processes, including DNA and histone methylation (epigenetic regulation), neurotransmitter synthesis, and phospholipid metabolism

Biguanides (metformin): Medications used to treat type 2 diabetes, metabolic syndrome, nonalcoholic fatty liver disease, and polycystic ovary syndrome can lead to decreased vitamin B12 absorption (5)

Laboratory tests will include: Standard blood tests to measure the level of red blood cells and check their appearance

B12 is also available in supplement form, either as part of a multivitamin or B-complex vitamin, or as a single supplement that contains only B12