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Thats why Isabella Leviyev, PA-C practices integrative medicine

And while the MTHFR variants primarily impact folate metabolism, the interconnectedness of the methylation cycle means that it indirectly affects vitamin B12 utilization as well

These early benefits are primarily from the B vitamin and L-Carnitine components

So, this isnt even a conversation you can be having with most of your athletes that are coming into this

Rather than directly supplying NAD+ precursors (like NMN or NR), it works by blocking an enzyme that consumes nicotinamide, theoretically preserving the substrate pool for endogenous NAD+ production