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It should be based on symptoms, lab results, medical history, MMA and homocysteine when needed, response to prior treatment, and the suspected reason for the deficiency

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Its entire activity profile derives from a single primary target — NNMT inhibition — which triggers a cascade of downstream metabolic effects: An important distinction: 5-Amino-1MQ does not raise NAD+ by supplying an external NAD+ precursor, as NMN or NR do