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The core mechanism of osteoporosis (imbalance of bone metabolism) Osteoporosis is essentially a negative balance between bone formation and bone resorption, resulting in continuous loss of bone mass, destruction of bone microstructure, increased bone fragility, and increased risk of fractures

Common causes include pernicious anaemia (autoimmune condition), plant-based diets without supplementation, gastrointestinal surgery, and long-term use of metformin or proton pump inhibitors

(More information) Both depression and osteoporosis have been linked to diminished vitamin B 12 status and high homocysteine levels

By inhibiting NNMT, the body maintains higher NAD levels, which in turn activate SIRT1, a longevity-associated gene, which may improve mitochondrial activity, fat oxidation, insulin sensitivity, and by overall energy balance