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Toxicity on basal lamina is thought to be the underlying mechanism (78)

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NAD+'s metabolic roles encompass several key pathways: Energy production : NAD+ regulates glycolysis, the citric acid (TCA) cycle, oxidative phosphorylation, and fatty acid oxidation by functioning as a cofactor for redox reactions Redox balance : The NAD+/NADH ratio controls flux through metabolic pathways, ensuring properly regulated cellular metabolism Mitochondrial function : NAD+ is essential for ATP synthesis through oxidative phosphorylation, where NADH donates electrons to complex I in the electron transport chain Biosynthetic processes : Through its phosphorylated form NADP+, it supports anabolic reactions and cellular antioxidant defense mechanisms NAD+ directly shapes cellular processes that maintain tissue homeostasis

I turned my friend on to it- and she has been taking it for a month by itself (as she doesnt have a real weight issue) and she has lost 8 lbs and saw a difference also in her hunger and energy level