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It inhibits NNMT (nicotinamide N-methyltransferase), an enzyme regulating metabolism, fat storage, and NAD+ consumption.[4][27][6] NNMT methylates nicotinamide, a NAD+ breakdown product, diverting it from recycling and reducing available NAD+

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Other indications include malabsorption disorders (such as Crohn's disease or coeliac disease), following gastric surgery, strict vegan diets without supplementation, and certain medications that interfere with B12 absorption

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It is widely recommended for individuals with severe insufficiency and malabsorption syndromes