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Vitamin B12 deficiency is believed to be widespread all over the world

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hepatic handling of the compound is uncharacterized in disease states) Individuals with chronic kidney disease (renal clearance of a small-molecule quaternary ammonium compound is expected to be impaired) Anyone on drugs with narrow therapeutic windows that depend on SAM-dependent metabolism, including COMT-substrate drugs Anyone under 18 years of age (no pediatric data of any kind) Anyone who has been diagnosed with, or is at elevated risk for, hormone-sensitive cancers (NNMT expression is altered in multiple cancer types