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On the other hand, an NAD + decrease also imposes deleterious effects on a variety of metabolic pathways.6 A major one is the sirtuin pathway,6 which is responsible for protein deacetylation.68 A decrease in NAD + would inactivate sirtuins, leading to overacetylation of proteins and less efficient glucose metabolism.69, 70, 71 In the case of NADH/NAD + redox imbalance, it has been demonstrated that restoring the redox balance by supplementing with an NAD + precursor or analogue is a valuable approach.72 In this regard, the recently identified precursor nicotinamide riboside is very promising as this chemical is more tolerant and has fewer sideeffects than niacin.73 For example, it has been reported that nicotinamide riboside can ameliorate diabetes and diabetic neuropathy in mice, and can enhance metabolism and prevent development of obesity induced by a high fat diet.74, 75 2.5

(2012) 7:e37883

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doi: 10.3389/fendo.2021.767785

When combined under medical supervision, they may provide a more balanced and robust growth hormone response than either peptide alone

BPC-157 accelerates repair, but mechanical stimulus (controlled loading) optimizes the quality of healing