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Several mechanisms are associated with the neuroprotective effect of NMNATs, including the suppression of ROS production, mitochondrial stabilization [120], promotion of the clearance of hyperphosphorylated Tau protein oligomers [121], autophagic clearance of amyloid plaques in Alzheimers disease models [122], and reduced accumulation of mutant Huntingtin (Htt) aggregation [123]

Serious reactions are rare

In those with non-celiac gluten sensitivity, it is possible that gluten is reducing DAO production in the gut, and removing gluten may be a simple root cause solution

Contact your GP for B12 testing if you have: Symptoms suggesting deficiency (persistent fatigue, pins and needles, memory problems, glossitis) Risk factors for deficiency (vegan diet, gastric surgery, long-term metformin or proton pump inhibitor use) [1] [4] Concerns about whether your current supplementation dose is appropriate Underlying conditions affecting B12 metabolism (kidney disease, liver disease) Unexplained high B12 levels on a blood test when not taking supplements Routine monitoring is essential for patients receiving therapeutic B12 injections

Well evaluate your symptoms, review your risk factors, and recommend the best course of actionincluding B12 therapy if indicated

Nature 583 (7816), 441446