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Increased Levels of Neurotransmitters: The medication increases neurotransmitters such as norepinephrine, serotonin, and dopamine

Because it is not renally filtered as an intact molecule in the same way small organic drugs are, its renal contribution is considered indirect, though the full elimination profile in humans has not been formally characterized

altering its production may affect downstream pathways in ways not yet studied long-term

NAD+ Flux Regulation: Studies focus on its mechanism of blocking NNMT, which may otherwise drain methyl groups and Nicotinamide, theoretically boosting the available pool of NAD+