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Do not stack modifiers unless you are mandated by your payer

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Difficulty swallowing or breathing (anaphylaxis) is also possible

Notes that alternative pathways such as polyamine biosynthesis could compensate for raised SAM, that partial rather than total inhibition may be preferable to avoid compensatory mechanisms from an imbalanced SAM/SAH ratio, and that the consequences of sustained NNMT inhibition on systemic epigenetics remain unclear