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Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes

Unlike NAD+ precursors that work downstream, 5-Amino-1MQ acts upstream by blocking NNMTs consumption of S-adenosyl methionine (SAM), resulting in elevated intracellular NAD+ and SAM levels without requiring direct nucleotide supplementation

Such as kisspeptin (a gonadotrophin releasing hormone analog for reproductive health, promoted for increasing libido) and KPV, lysine-proline-valine, an alpha melanocyte-stimulating hormone, with purported anti-inflammatory and wound healing effects