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It is also involved in cell metabolism affecting energy and overall metabolic health

Matern D, Tortorelli S, Oglesbee D, Gavrilov D, Rinaldo P

Healthy Aging An essential coenzyme 7 in the metabolism of cellular energy is NAD+

The pharmaceutical industry abandoned GH secretagogue development in the early 2010s not because the compounds don't workPhase 3 trials consistently demonstrated GH and IGF-1 elevationbut because the therapeutic window for meaningful clinical outcomes (muscle preservation in cachexia, bone density improvement in osteoporosis) was too narrow relative to metabolic side effects like glucose intolerance

Thompson GJ, Riedl V, Grimmer T, Drzezga A, Herman P, Hyder F