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Blood tests including serum B12 levels can diagnose deficiency, and in some cases, additional tests such as intrinsic factor antibodies (to identify pernicious anaemia) may be appropriate

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NAD+/NADH ratio assays, SIRT1 activity assays, and mitochondrial respiration measurements (such as oxygen consumption rate via extracellular flux analysis) are standard methods for studying this combination's proposed effects in cell-based models, typically comparing single-compound and combined-compound treatment conditions against untreated controls

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Importantly, NNMTi is highly selective and has no inhibitory effect on other SAM-dependent methyltransferases or NAD + salvage pathway enzymes