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It is particularly common in individuals with certain risk factors, including those who have undergone gastric or small intestine resections, have inflammatory bowel disease, use metformin or proton pump inhibitors, follow a vegan diet, or are older than 75 years

The recommended daily intake (RDI) of vitamin B12 for adults over 19 is Deficiency is common, especially in people who follow a vegetarian or vegan diet

NNMT upregulation also elevates homocysteine levels, activating pro-inflammatory and pro-oxidative cascades (TLR4-NF-B and STAT3-IL-1 pathways) linked to atherosclerosis, heart failure, and coronary heart disease

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