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When adverse effects occurred, they were typically mild and transient, with the most common being mild to moderate headaches (similar frequency to placebo groups), minor injection site reactions (redness, slight swelling), and gastrointestinal effects at higher oral doses (nausea, diarrhea)
Inhibiting the enzyme therefore has consequences on two fronts at once: it spares S-adenosylmethionine, and it leaves nicotinamide available to other routes, including the salvage pathway that supplies NAD
Groups switched from WD to LD had a greater average relative abundance of Verrucomicrobia (represented solely by the genus Akkermansia )
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