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Since NNMT is expressed in adipose, hepatic, and gut tissues 50,51,52 , and these tissues heavily cross-talk with the gut microbiome 53,54,55 , NNMTi treatment or its resulting weight loss effects 8,9 may modulate the microbiome

Warning signs include persistent fatigue despite adequate sleep, cold intolerance (especially cold hands and feet), menstrual irregularity or cessation in female subjects, hair thinning or shedding, and mood disturbances (irritability, low motivation)