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Beyond its role in serotonin synthesis, tryptophan plays a central role in the kynurenine pathway, a metabolic pathway critical for the production of nicotinamide adenine dinucleotide (NAD+), a molecule essential for ATP generation in cellular metabolism (Savitz, 2020) (Figure 5)

The current evidence base points to several overlapping molecular pathways operating in parallel: VEGFR2/Akt/eNOS Angiogenic Signalling A primary mechanistic axis involves upregulation of vascular endothelial growth factor receptor 2 (VEGFR2), leading to activation of the Akt/eNOS (endothelial nitric oxide synthase) downstream pathway

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