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In states of obesity and metabolic dysfunction, NNMT is often overexpressed in adipose tissue, depleting nicotinamide and reducing NAD+ availability [2]

This protocol is not suitable for people who do not absorb the vitamin well for any reason (macro doses should be used)

195,196,197 At the cellular level, this translates into a massive increase in cytoplasmic Na + concentration, membrane depolarisation and opening of voltage-gated Ca 2+ channels, which in turn promotes massive release of glutamate that results in even large depolarisation enlarging Na + and Ca 2+ influx thus completing the vicious circle of excitotoxic damage, as Ca 2+ overload triggers necrotic cell death

Animal studies have shown a suppression of autophagy in activated microglia and infiltrating macrophages following TBI (Hegdekar et al., 2023)