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The "as needed" approach reflects that NAD+ is a coenzyme, not a receptor agonist there's no desensitization concern in the same way

This is in part of only having animal trials while human trials are still on their means

Vitamin B12 is key for making red blood cells and keeping nerves healthy

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B12 may not be a highly influencing factor for kidney function, but it is undoubtedly important when treating kidney diseases

Basic properties and clinical applications." Expert Opinion on Biological Therapy