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Furthermore, NAD levels in the brain are essential for maintaining central nervous system (CNS) vascular integrity, due to NAD maintaining an energy supply that plays crucial roles in cell survival, such as having a protective factor in cerebral ischemia, since its disorder leads to energy depletion (13, 52)

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The compounding of estrogen decline and GH decline in the same window produces particularly pronounced fatigue, body composition changes, and sleep disruption