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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

A limitation of our study is that we have focused on vitamin B 12 deficiency without measuring other biomarkers that are associated with vitamin B 12 status, such as homocysteine, methylmalonic acid and holo-transcobalamin