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NNMT is an enzyme that catalyzes the transfer of a methyl group from S-adenosylmethionine (SAM) to nicotinamide (NAM), producing 1-methylnicotinamide (MNA) and S-adenosylhomocysteine (SAH)

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Common causes include herniated or bulging lumbar discs (the most frequent cause), spinal stenosis, degenerative disc disease, piriformis syndrome, and spondylolisthesis