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Unfortunately, NAD+ levels decline with age, stress, poor diet, and metabolic dysfunction

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In comparison with that metaanalysis, our findings show that the addition of silymarin to BBR is able to improve its positive effect on lipid and glucose metabolism in humans, allowing for the administration of lower doses of BBR and accordingly reducing the associated risk of gastrointestinal discomfort which is demonstrably dose related (Caliceti, Rizzo, & Cicero, 2015

While the exact mechanisms remain unclear, two primary theories have been proposed: 1) an immune-mediated systemic reaction causing vasoconstriction and a prothrombotic state leading to ischemia and subsequent stroke