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Theres no studies yet to show why this may be - whether its the effect from intense cardio or whether those who enjoy running more commonly have a naturally higher metabolism - and it doesnt seem to happen for all runners

In obesity, NNMT activity is unusually high in fat cells, which means a lot of nicotinamide gets thrown out before it can be turned into NAD+

Presence of other medical conditions: Conditions like liver disease or kidney failure can increase bleeding risk

Document the fracture pattern and reduction

Mecobalamin should be used with caution in individuals with a history of heart disease, particularly if they are at risk for arrhythmias, as large doses may cause changes in heart rhythm