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In white adipose tissue of obese, insulin-resistant and aged mammals, NNMT is dramatically upregulated and because it consumes both the universal methyl donor (SAM) and the NAD precursor (nicotinamide), its hyperactivity simultaneously depletes the cellular methylation reserve and the NAD-salvage pool [1,2]

NHS eligibility criteria are more restrictive than the licensed indications and include higher BMI thresholds and the presence of weight-related complications

But Australian rheumatologists, who were not involved in the research, said the study had several limitations that made it difficult to draw any conclusions or recommend B12 for fibromyalgia patients

The most commonly reported side effect is mild injection site irritation in the early weeks, which typically resolves

Foods rich in vitamin B12 include mushrooms, nutritional yeast and animal products such as meat, dairy, butter and eggs