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As fat tissue grows and more NNMT is produced, higher amounts of hormones and pro-inflammatory signals are produced that are responsible for weight gain and other chronic diseases such as type 2 diabetes and cardiovascular disease. NNMT is responsible for converting nicotinamide (NA) into 1-methylnicotinamide (1-MNA), which takes it out of the NAD salvage pathway (see the diagram below)

Blocking DHT (e.g

It is not a replacement for these medications but rather a different approach targeting a distinct metabolic pathway

For instance, treating both tennis elbow and trigger finger in the same patient requires this modifier on the second procedure to avoid bundling denials