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For instance, Joe Rogan once shared a personal experience: I had tendonitis in my elbow that I just could not fix

(2019a)

It uses a methyl group donated by S-adenosylmethionine (SAM) to methylate nicotinamide a vitamin B3 form that would otherwise be recycled back into NAD+

In the absence of impaired kidney function, an elevated MMA level in conjunction with elevated homocysteine suggests either a vitamin B 12 deficiency or a combined vitamin B 12 and folate deficiency (32)