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In mouse models of high‑fat diet‑induced liver steatosis, it significantly inhibits hepatic NNMT activity, reduces NAM methylation, increases NAD+ and SAM levels, enhances mitochondrial fatty acid oxidation, reduces hepatic triglyceride and lipid accumulation, lowers lipotoxicity markers (e.g., malondialdehyde, transaminases), improves hepatocellular injury, and reverses steatosis

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Additionally, cases of ME/CFS have also been recorded post-immunization (163) and many patients are fearful that vaccinations will worsen their already dysfunctional immune system and cause symptom exacerbation (164)