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Dry mouth is the most common and persistent side effect and as many patients discover, it has an unintended benefit: it naturally drives increased water intake throughout the day

Protocols vary, but many clinics structure treatment in cycles of several weeks to a few months, with periodic reassessment to determine whether to continue, taper, or discontinue therapy

Research in preclinical models has explored its role in NNMT inhibition, NAD+ metabolism, and cellular energetics (pmc.ncbi.nlm.nih.gov, pubmed.ncbi.nlm.nih.gov)

Patients found to have a low serum cobalamin level in the absence of anaemia and who do not have food malabsorption or other causes of deficiency, should be tested for IFAB to clarify whether they have an early or latent presentation of pernicious anaemia