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Moreover, prophylactic B12 supplementation should be used from prepregnancy until the end of the lactation period in women with previously diagnosed B12 deficiency or who are at risk of vitamin B12 deficiency due for instance to low dietary intake of B12

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Physician experts were consulted to estimate the resources and costs of converting patients to oral supplements

Additionally, the NNMT substrate nicotinamide 12 is metabolized by the microbiome 56,57 , and thus NNMTi may modulate substrate availability, potentially influencing microbial metabolic capacity to drive the NNMTi-mediated weight loss

Last reviewed: June 6, 2026 Last updated: June 6, 2026 Written by: Jay Hastings, CEO of PlexusDx Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations