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Autoantibodies have been identified which interfere with the ability of the FR to function

References References Selective and membranepermeable small molecule inhibitors of NNMT Roles of Nicotinamide NMethyltransferase in Obesity and Type 2 Diabetes Nicotinamide Nmethyltransferase inhibition mimics and boosts exercisemediated improvements in muscle function in aged mice Reduced calorie diet combined with NNMT inhibition establishes a healthier gut microbiome in obese mice Kraus et al

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You could run a single peptide and address one aspect of the problem