Figure 1. Enzymatic pathway for NAM methylation.
Nicotinamide (NAM) is methylated by nicotinamide N-methyltransferase (NNMT) using the universal methyl donor S-Adenosylmethionine (SAM). The methylated product N1-methylnicotinamide (MNAM) is further oxidized by aldehyde oxidase (Aox) into two related compounds 2py and 4py. All three metabolites are eventually excreted in the urine.