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As fat tissue grows and more NNMT is produced, higher amounts of hormones and pro-inflammatory signals are produced that are responsible for weight gain and other chronic diseases such as type 2 diabetes and cardiovascular disease. NNMT is responsible for converting nicotinamide (NA) into 1-methylnicotinamide (1-MNA), which takes it out of the NAD salvage pathway (see the diagram below)

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While topical application has minimal systemic absorption, the precautionary principle suggests avoiding use during pregnancy unless a healthcare provider approves

Peripheral vascular thrombosis: Increased risk of clotting in individuals with elevated levels

Serious Vitamin B12 deficiency can result in decreased number of red blood cells (anemia), stomach or intestinal diseases and permanent nerve damage