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DOI: 10.1371/journal.pone.0169283

Study 3: Combination With Diet Independent work showed that NNMT inhibition plus a lean/low-fat diet accelerated weight and fat loss beyond diet alone, improved the lean-mass-to-body-weight ratio, and ameliorated obesity-linked liver pathologies

Sometimes symptoms can take years to show up as a deficiency, these symptoms include *Lack of energy *Muscle weakness *Extreme fatigue or tiredness *Yellow eyes *Pale or slightly yellow tinge to skin tone *Pin and needles (paraesthesia) *Shortness of breath and dizziness *Disturbed vision *Sore and or red tongue *Depression *Mouth ulcers *Psychological problems *Changes in mobility *Memory loss and understanding problems Vitamin B12 deficiency can be easily avoided, many people are becoming new to a vegan or vegetarian diet and are unaware of the need to combine sources of plant proteins

167,171,172 Management strategies focus on tight glycemic control to prevent further nerve damage, symptomatic treatment with analgesics for pain management, physical therapy to maintain muscle strength and prevent contractures, and surgical interventions for entrapment neuropathies when necessary