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By midlife, NAD+ can drop by 50%, exacerbated by inflammation and lifestyle.[14] Factors like poor diet, sedentary behavior, or chronic stress further deplete NAD+ by activating consuming enzymes, creating a vicious cycle

For patients in South Florida, the heat outside the refrigerator is an especially important factor: a peptide vial left on a counter in a Doral kitchen during summer is exposed to ambient temperatures that can reach the mid-80s Fahrenheit or higher, which meaningfully accelerates degradation for any reconstituted solution left out during injection preparation

Most patients self-administer at home

Clinical studies used vastly different protocols