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As you get older, the systems that rely on NAD+ (like energy production, cognitive function, skin repair, immune health, and inflammation regulation) start to slow down, and declining NAD+ levels appear to be a key driver behind that slowdown

THE GH, IGF-1, AND INSULIN INTERPLAY IN TYPE 2 DIABETES MELLITUS AND OBESITY Patients with chronic liver disease are prone to developing sarcopenia, which is defined as loss of skeletal muscle mass, strength, and function, and is associated with increased morbidity and mortality [23]

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Your blood tests might look perfect, but your bodys still running on empty because those genetic variants are creating traffic jams in your conversion process