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A balanced NAD + /NADH ratio is critical for continuous generation of ATP

As an extreme form of prolonged endurance exercise, ultramarathon running provides a unique model to study such effects under maximal physiological strain

There are no large, well-controlled human trials proving that this combination helps with healing, fat loss, or anti-ageing, meaning most claims are just marketing

Many men report these improvements as among the most valued benefits of weight loss

A large proportion come from China, where imports of hormone and peptide compounds have increased dramatically: US customs data shows they hit $328m in the first three-quarters of 2025, up from $164m in the same period the previous year, the New York Times reported