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Generally, NNMT activity or expression is significantly elevated in cancers, such as brain [68], lung [69], liver [70], kidney [71, 72], bladder [73], stomach [74, 75], pancreas [76], colon [77], and oral [78, 79] cancer but cancer cells usually have a significantly higher anaerobic metabolism rate than normal cells

Options for managing tolerance include a brief dose reduction for 4 to 8 weeks ("drug holiday" at a lower dose, not complete cessation), lifestyle optimization to maximize the medication effect, evaluation for other contributing factors (thyroid function, cortisol, sleep quality, medication interactions), and consideration of adding a complementary compound to address specific aspects of the plateau

With timely testing, structured supplementation, dietary correction, and lifestyle adjustments, both deficiencies can be corrected effectively

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