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Hu Q, Liu F, Yang L, Fang Z, He J, Wang W, You P (2020) Lower serum nicotinamide N -methyltransferase levels in patients with bipolar disorder during acute episodes compared to healthy controls: a cross-sectional study

Altogether, initial reports of NAD + precursors and exercise in clinical trials, while encouraging in certain instances, are still too inconclusive to directly link an increase in NAD + levels and mitochondrial metabolism to established health benefits in humans

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If there has been long-standing damage, this triggering might overwhelm the system, temporarily worsening symptoms

Full disclosure: Inform your healthcare provider about any existing medical conditions, especially diabetes, thyroid issues, or a family history of medullary thyroid cancer or multiple endocrine neoplasia type 2