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Patients taking long-term medications that reduce stomach acid, including proton pump inhibitors (omeprazole, lansoprazole) or H2-receptor antagonists (famotidine), may also develop deficiency after several years of use

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NNMT inhibition preserved nicotinamide substrate pool Reduced nicotinamide methylation conserved S-adenosyl methionine Elevated intracellular NAD+ increased sirtuin pathway activity Adipocyte metabolic shift altered lipid handling in cell models Core Areas of Scientific Investigation NNMT Enzyme Inhibition: NNMT activity is elevated in adipose tissue in obesity models