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At the enzyme level, 5-Amino-1MQ inhibits NNMTs methylation of nicotinamide reducing intracellular 1-MNA levels and diverting nicotinamide back into the NAD+ salvage pathway (via NAMPT-mediated conversion to NMN and subsequently NAD+)

The exceptions are kisspeptin (dosed per kg in research settings) and some practitioners who adjust TB-500 loading doses for users over 250 lbs (increasing from 5 mg to 7.5 mg twice weekly)

Some studies suggest the quinolinium structure is sufficiently NNMT-selective that it should not broadly deplete SAM, but the wider metabolic picture remains an active research consideration

Second, inhibition of lipogenesis

Long-term acid reflux medicines can block absorption