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Its value in a clinical setting comes from what it is not: it does not disrupt appetite, hormones, insulin, or IGF-1

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(Aureli A, et al., International Journal of Molecular Sciences, 2023 PubMed: 38068911 ) B12 and lipid metabolism A review of pre-clinical and clinical evidence found low B12 is associated with adverse lipid profiles including elevated total cholesterol and LDL, particularly in people with type 2 diabetes

Interaction with fasting and ketosis Both fasting and ketogenic diets increase NAD+ levels through various mechanisms