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Reductions of this magnitude are rare in addiction medicine and what's remarkable is that the finding came from drugs initially designed for diabetes, later repurposed for obesity and never intended to treat addiction

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Baseline IGF-1 level and age are the strongest predictors of magnitude

While multiple mechanisms may exist for these increases, it is widely appreciated that increased oxidative potential enhances receptor-mediated downstream responses

doi: 10.1002/1873-3468.13428 94 HudryE.DashkoffJ.RoeA

With advancing age, cellular NAD levels decline significantly through three main mechanisms: reduced synthesis (decreased NAMPT), increased catabolism (CD38 hyperactivation under inflammaging conditions) and excessive consumption by DNA repair systems. Intravenous administration of NAD or its precursors such as NR (nicotinamide riboside) and NMN (nicotinamide mononucleotide) aims to restore a more youthful biosynthetic and reparative capacity to ageing cells