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(Swaminathan et al., 2017), the X-ray crystal structure of a ternary complex of NNMT bound with MNAM was elucidated, revealing that MNAM binds to the active site of NNMT, thereby impeding NAM binding and suppressing NNMTs enzymatic activity

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The short answer: the ideal needle size for a B12 injection depends on the injection method

I have self injected upper arms for the last three or so years now,Ive did hundreds of injections and the only time I feel pain is if Im lucky enough to have a nurses appointment,other than that I feel totally in control of any pain risks and although I admit I still hate doing them its not because its painful its just needle phobia in my case

[1] If a rash or generalized itching develops, the injection should be halted and the patient evaluated, as it could be a prodrome of a more serious reaction

In a patient with normal B12 status, injecting more of it does not create surplus energy or burn fat