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In the Krebs cycle, adenosylcobalamin can induce the accumulation of succinate, an antagonist of histone and DNA demethylation reactions catalyzed by enzymes of the 2-oxoglutarate-dependent dioxygenase family, which may favor the activation or inhibition of gene expression ( Figure 5 )

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While tirzepatide slows gastric emptying and reduces caloric intake through incretin receptor activation, 5-amino-1MQ works intracellularly to inhibit nicotinamide N-methyltransferase (NNMT), shifting cellular metabolism toward fat oxidation independent of appetite suppression