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This group also reported that low maternal vitamin B-12 plasma concentrations in pregnancy were correlated with insulin resistance, as measured by the HOMA-IR in children aged 6 y (39)

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[2] It is important to note that whilst fatigue and general malaise may improve relatively quickly, complete symptom resolution requires adequate time for the body to replenish B12 stores and repair affected tissues

Simultaneously, higher S-adenosylmethionine (SAM) availability supports key methylation-dependent pathways, which are crucial for epigenetic regulation and gene expression related to energy metabolism

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When NNMT activity is high: NAD levels drop, impairing mitochondrial energy production