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And conditions that lead to low stomach acid also lead to a myriad of nutrient deficiencies, including B12 deficiency

That is a far better reason to combine two compounds than the fact that they are sold in the same box

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The initial metabolic shift becomes perceptible

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The first cardiovascular study of NNMT enzyme inhibition in a heart failure with preserved ejection fraction (HFpEF) mouse model demonstrated that treatment markedly reduced 1-MNA (by 77.1%), 2PY (by 66.2%), and 4PY (by 71.1%) in cardiac tissue, while improving cardiac function, enhancing global longitudinal strain, reversing peak longitudinal strain rate, and significantly reducing left ventricular hypertrophy and fibrosis