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A lack of stomach acid occurs in elderly patients and among people taking proton pump inhibitors, leading to poor digestion of the vitamin from animal products

For example, several studies support a causal relationship between augmented NNMT activity in cancer cells and tumor proliferation/progression in a variety of cancerous states with potential implications for NNMT as a biomarker for cancer prognosis and a relevant target for anti-cancer therapeutic development

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Its likewise crucial to note that, as with any supplement, especially one that is relatively new and not extensively studied, caution must be exercised regarding its use