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They are not approved for diagnostic, therapeutic, or recreational use

Overexpression of NNMT has been linked to obesity, insulin resistance, and impaired NAD metabolism

GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord

It is used for correcting or preventing vitamin B12 deficiency

Nevertheless involvement in the audit stimulate a considerable change in behaviour among participating doctors, leading to subsequent improvement in their use of vitamin B12