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Malabsorption from coeliac disease, Crohns, gastric surgery or long-term metformin and proton-pump inhibitors accounts for much of the rest

Improved energy levels: Reduction in afternoon fatigue and improved stamina during exercise, particularly in patients who were already physically active before starting

It must also be recognized that changes in protein binding may lead the unwary to believe there is a change in clearance when in fact drug elimination is not altered (see Box: Plasma Protein Binding: Is It Important?)

Please, if you feel strongly on this issue, ask your MP to get involved

Nicotinamide N-methyltransferase (NNMT): a novel therapeutic target for metabolic syndrome in aging