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One possible explanation is that low serum vitamin B12 levels would trap folate as 5-methyltetrahydrofolate, prevent the generation of methionine from homocysteine, and therefore reduce protein synthesis and lean tissue deposition

This scoring system allowed for semi-quantitative evaluation of cartilage integrity based on macroscopic features such as softening, fibrillation, erosion, ulceration, and complete cartilage loss [1]

Human studies demonstrate sustained, dose-dependent increases in both GH and IGF-1 with subcutaneous administration [1]

[1] In cultured mouse adipocytes, exposure to a methylquinolinium NNMT inhibitor raised intracellular NAD+ and SAM and lowered lipogenesis