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Because NAD+ is used in hundreds of enzymatic reactions throughout the body, particularly in tissues with high energy demands, replenishing NAD+ levels directly via injection may support a more robust and sustainable cellular response

Yang Y, Wang Y, Guo L, Gao W, Tang TL, Yan M

Also, Drosophila , lacking, or deficient in parkin, exhibit mitochondrial deficits and high vulnerability to oxidative stress (Saini et al., 2010)

If needed for a clear medical indication (such as treating pellagra in a pregnant patient), niacinamide can be used with caution, but unnecessary high-dose B supplementation is avoided in pregnancy