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Tissue-level deficiency of cobalamin is associated with an increase in the urinary and serum concentrations of an organic acid called methylmalonic acid, which is an alternative product of a cobalamin dependent pathway within the mitochondria

By inhibiting NNMT, the compound preserves these critical cofactors, restoring sirtuin activity and normal energy expenditure in adipocytes

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The vitamin/mineral supplement in this study contained molybdenum (150 mcg for a 30 kg child), so this may also have contributed to increases in sulfate levels