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The condition involves dysregulation of neurotransmitters, inflammatory mediators, and stress response systems, producing a constellation of symptoms extending far beyond pain to include crushing fatigue, unrefreshing sleep, cognitive dysfunction known as fibro fog, and heightened sensitivity to temperature, sound, and light

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NNMT (nicotinamide N-methyltransferase) is the enzyme 5-Amino-1MQ inhibits, and tissue expression varies significantly across organs: adipose tissue shows 812 higher NNMT activity than skeletal muscle, which is why subcutaneous injection near adipose depots produces localised effects rodent models couldn't predict

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Cell Death Differ 14(9):1667-1677, 2007