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This is especially true given that many emerging therapeutics are costly, may entail significant logistical burdens for patients and caregivers, and, importantly, carry substantial risks of adverse effects

After being boosted through precursor supplementation, NAD+ often plateaus and declines around week 12, which is likely due to an overabundance of NAM (a byproduct of NAD+) and a shortage of methyl donors present to fuel conversion in the salvage pathway.38 Supplementing with a potent methyl donor can offset this shortage and ensure sustained activity in the salvage pathway

Lancet 46 GolzL.MemmertS.Rath-DeschnerB.JagerA.AppelT.BaumgartenG.et al (2014)

[DOI] [PMC free article] [PubMed] [Google Scholar] 111.Wolbold R, Klein K, Burk O, Nssler AK, Neuhaus P, Eichelbaum M, et al