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Research in preclinical models has explored its role in NNMT inhibition, NAD+ metabolism, and cellular energetics (pmc.ncbi.nlm.nih.gov, pubmed.ncbi.nlm.nih.gov)

If you feel like over the last year you've noticed some improvement still from year one to year two post-transplant, then it's possible that you'll continue to notice a little improvement

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PubMed Pickart, L., & Margolina, A

Like I said, some doctors go two more cycles