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Elevates NAD+ and S-adenosylmethionine (SAM) levels, shifting metabolic flux toward energy expenditure and away from fat storage 1-4

phenobarbital induces hepatic enzymes, reducing the bioavailability of warfarin)

Other reasons include: bariatric surgery or bowel resection, age, those with GI diseases such as Crohns and Celiac, people taking Metformin to control their blood sugar and thos taking proton pump inhibitors (Prevacid, Prilosec, etc) for chronic heartburn

Consistency, rest, and supportive care play important roles in achieving optimal results

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