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In cats, low B12 almost always points to gut malabsorption, not diet alone, and is common with chronic GI disease

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The review confirmed that NNMT-mediated NAD+ depletion impairs mitochondrial function, SIRT activity (particularly SIRT1 and SIRT3), redox balance, and energy metabolism, creating conditions relevant to cardiovascular disease research models

Summary Keywords endocrinology, growth hormone secretagogues, IGF-1 analogues, off-label use, peptide hormones, performance-enhancing drugs, sports doping Citation Dominikowski A, Rko Z, Olejarz M, Szczepanek-Parulska E, Domin R and Ruchaa M (2026) The emerging landscape of performance-enhancing peptides modulating GH-IGF1 axis: bridging the gap between clinical evidence and patient self-administration

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