I know you didn't mention that as an issue, but I feel there is some link between B12, cystic acne, mast cell dysfunction, gastroparesis and probably many other symptoms
Celiac disease : The autoimmune disorder damages the small intestine, where B12 is absorbed for use in the body
It takes 5 minutes and can reveal a problem that has no symptoms
ARA-290 also activates survival pathways within cells
It was identified through a medicinal chemistry programme at the University of Texas Health Science Center as the lead NNMT inhibitor candidate among a series of 1-methylquinolinium analogues bearing primary amine substitutions, selected for its combination of high passive membrane permeability (confirmed in PAMPA assays), high active transport membrane permeability (confirmed in bidirectional Caco-2 cell assays), potent NNMT inhibitory activity, and high selectivity including confirmed absence of inhibitory effects on related SAM-dependent methyltransferases or enzymes in the NAD+ salvage pathway
Fiber Intake Predicts Weight Loss and Dietary Adherence in Adults Consuming Calorie-Restricted Diets: The POUNDS Lost (Preventing Overweight Using Novel Dietary Strategies) Study