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[2] Causes are usually related to conditions that give rise to malabsorption of vitamin B 12 , particularly autoimmune gastritis in pernicious anemia

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In an online survey, almost one third of 683 participants reported cancellation of B 12 injections during the covid-19 lockdowns, with subsequent worsening of symptoms and often with negative emotions and feelings including anger, fear, disappointment, feeling let down, and feeling undervalued

NNMT consumes S-adenosylmethionine (SAM) and methylates nicotinamide, depleting cellular methyl pools and downstream NAD+ precursors