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Studies show that NNMT inhibition by 5-amino-1-methylquinolinium significantly reduces nicotinamide metabolism, increases NAM accumulation, improves NAD+ synthesis efficiency by over 30%, and markedly increases mitochondrial ATP production and cellular energy metabolism

[10] [11] Intramuscular B12 injections (hydroxocobalamin or cyanocobalamin) bypass the digestive system, but UK product information (SmPCs) for hydroxocobalamin injections does list gastrointestinal disturbances, including diarrhoea, as possible adverse reactions, albeit rare

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10.1039/c2nr33072e 121 ZhuJ

Antioxidants neutralize ROS and protect cells from oxidative stress, and cancer cells exploit antioxidant defense mechanisms to counteract chemotherapy-induced ROS accumulation, thereby promoting survival