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Long term prescription of medications such as the following are likely to increase the cause of, or exacerbate the risk of B12 deficiency - the proton pump inhibitors (esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole), famotidine, ranitidine, metformin, glibenclamide, gliclazide, glimepiride, glipizide, sodium valproate, gabapentin, doxycycline, some oral contraceptives

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So, without these vitamins, enzymes remain inactive and cannot catalyze specific methylation reactions for the synthesis, activation, or degradation of hormones

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Preclinical Metabolic Models: Cell and animal research has investigated NNMT inhibition in relation to adipocyte biology, cellular energy expenditure and metabolic signaling