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In states of obesity and metabolic dysfunction, NNMT is often overexpressed in adipose tissue, depleting nicotinamide and reducing NAD+ availability [2]

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Vajro, P., Paolella, G

In limited data it's generally reported as well-tolerated, but human safety data is still limited and long-term effects aren't fully characterized

The good news: All forms of B12 supplements are relatively safe and can help you sidestep symptoms of a deficiency

Fatigue appears in 8-12% of users, though distinguishing medication-induced fatigue from diet-related energy deficits proves difficult