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Adjust dose, wait 1-2 weeks to assess, then consider other changes if needed

(2023) Endocrine Reviews , 44(6): 10471073 (Harvard Medical School / University of Pennsylvania) Comprehensive review establishing NAD+ as a cofactor for sirtuins, PARPs, and CD38 enzymes, confirming age-related NAD+ decline as a driver of mitochondrial dysfunction and nuclear-mitochondrial communication breakdown

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Diagnosing PA: the commonest non-nutritional cause of vitamin B deficiency Given how NICE guidelines are used in practice, we find that the guidelines lack specific advice on the clinical scenarios in which practitioners should suspect AIG and PA