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In fibromyalgia, oxidative stress has also been linked to pathophysiology (Cordero et al., 2010) with studies suggesting that antioxidant therapies may help reduce elevated pro-oxidative pathways such as lipid peroxidation and mitophagy (Assavarittirong et al., 2017) with melatonin being shown to improve brain function in the GWS model, through modulation of oxidative stress (Madhu et al., 2021)

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The study found that NNMT inhibitors "reduced intracellular 1-MNA, increased intracellular NAD+ and S-(5-adenosyl)-L-methionine (SAM), and suppressed lipogenesis." This metabolic improvement occurs within days of starting treatment, before any weight loss becomes measurable

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