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Studies show this delay can be 20-40% compared to baseline (Jalleh et al., 2023)

doi: 10.1016/j.imlet.2006.09.005 9 BeckerAThakurBKWeissJMKimHSPeinadoHLydenD

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NAD+ levels fall ~50% between young adulthood and age 60 due to increased CD38 expression (which degrades NAD+) and accumulating DNA damage that depletes pools via PARP activity

They are contraindicated in patients with a personal or family history of medullary thyroid cancer and should be used cautiously in those with a history of pancreatitis