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NNMT is an enzyme that regulates energy metabolism by methylating nicotinamide, a precursor to NAD+, into 1-methylnicotinamide

In mouse models of highfat dietinduced liver steatosis, it significantly inhibits hepatic NNMT activity, reduces NAM methylation, increases NAD+ and SAM levels, enhances mitochondrial fatty acid oxidation, reduces hepatic triglyceride and lipid accumulation, lowers lipotoxicity markers (e.g., malondialdehyde, transaminases), improves hepatocellular injury, and reverses steatosis

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These findings matter for Lyme patients, since persistent inflammation and tissue damage are key drivers of symptoms