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Rat studies have noted embryofetal mortality, structural abnormalities, and alterations to growth at maternal exposures below the maximum recommended human dose (MRHD) based on exposure AUC

Because NNMT activity intersects methyl donor utilization and nicotinamide handling, experimental inhibition can be used to probe pathway level relationships among methyl economy balance, NAD+ salvage flux, and downstream metabolic signaling in a range of preclinical systems

A subset of clinical research has also demonstrated that adding B12 (and other B-vitamins) to existing antidepressant regimens can improve response rates compared to antidepressants alone, particularly when baseline B12 was suboptimal

It is one of the most widely studied and prescribed FDA-approved weight loss medications