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When NAD+ falls, mitochondrial output drops, and patients typically describe fatigue that does not respond to sleep, sluggish recovery from workouts, low motivation and reduced stamina

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Mitochondrial dysfunction is considered to play an underlying role in bipolar disorder, and abnormal accumulation of mitochondrial Ca 2+ is a potent trigger of necrosis, apoptosis, and autophagy [15,16,17,18]

Under physiological conditions, NAD + is continuously synthesized and catabolized mainly by three pathways