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These might include: Persistent fatigue that seems disproportionate to liver disease severity Glossitis (sore, red tongue) or mouth ulcers Shortness of breath and palpitations due to anaemia Difficulty concentrating or 'brain fog' Mood disturbances including irritability or depression It is crucial to recognise that some symptomsparticularly fatigue and cognitive changesare common in both fatty liver disease and B12 deficiency, potentially leading to delayed diagnosis

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Currently, there is no practical way to measure individual NNMT activity to predict response

The period between uses should be at least 2 hours

it also plays a role in brain function