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In colon epithelia, clostridium perfringens enterotoxin causes focal leaks by targeting claudins which are apically accessible due to tight junction derangement

Some researchers also track NAD+ metabolite levels via urinary nicotinamide excretion to confirm functional NNMT inhibition, though this is not standard practice

Changes in vision In extreme cases, a lack of B12 may damage the optic nerve or plug up the blood vessels in the retina, causing blurry vision, double vision, sensitivity to light, and even vision loss, per research in Cureus

As of yet, there is no good study of the use of glutathione in healthy people