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NNMT sits at high levels in fat tissue, in many cancer cells and in tissue under metabolic stress, where it acts as a metabolic sink: it consumes NAD+, the coenzyme that powers energy production and cell repair, and S-adenosylmethionine (SAM), the cell’s main methyl-group donor

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According to multiple meta-analyses, MTHFR C677T and A1298C increase the relative risk for high homocysteine, cardiovascular disease, stroke, neural tube defects, certain pregnancy issues, depression, migraines, and some neuropsychiatric conditions, especially with low folate/B vitamins.[ref] These same variants can lower the risk for certain conditions as well, illustrating tradeoffs of both positive and negative effects