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KPV antimicrobial properties and its activity against fungal organisms may be relevant here

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[8] For these reasons, B12 deficiency is a commonly reported nutritional deficiency following gastric sleeve surgery , with studies and BOMSS guidance indicating that without appropriate supplementation, a significant proportion of patients will develop suboptimal B12 levels within one to two years post-operatively

NA cannot be salvaged into NAD + any longer if it is N-methylated by NNMT, so the methylation of NA impairs the abundance of free NAD + and then affects the activities of these NAD + -consuming enzymes [19]