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Deficiency causes megaloblastic anemia abnormally large, dysfunctional red cells that impair oxygen delivery, producing fatigue, shortness of breath, and pallor

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Interestingly, transient type I IFN gene expression in peripheral blood is a suggested risk factor preceding autoantibody seroconversion and autoimmunity in children with a genetic predisposition to T1D, though not all children progress to the disease (116, 117)

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Notes that alternative pathways such as polyamine biosynthesis could compensate for raised SAM, that partial rather than total inhibition may be preferable to avoid compensatory mechanisms from an imbalanced SAM/SAH ratio, and that the consequences of sustained NNMT inhibition on systemic epigenetics remain unclear