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A meta-analysis published in the Journal of Ethnopharmacology reviewed multiple randomized controlled trials examining berberine supplementation

Some patients may require laboratory testing before treatment, while others may not

Fatty liver disease affects roughly 30% of adults in developed nations, often silently progressing without symptoms until significant liver damage occurs

Barbieri JS, Spaccarelli N, Margolis DJ, James WD

According to Kannt & Pfenninger in Frontiers in Physiology , NAD is a critical coenzyme in mitochondrial energy metabolism, and strategies that preserve NAD have wide-ranging effects on health and performance (Kannt & Pfenninger, Frontiers in Physiology )

If you are consistently below this at 5mg for several months, this would typically prompt a conversation about whether moving to 7.5mg is appropriate