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It is therefore better practice to look for trigger symptoms which are explained below

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Production of NAD+ declines sharply with age, leading to hidden cellular damage and visible symptoms like wrinkles, stubborn fat, cognitive fog, delayed recovery, and joint discomfort.[1][2][3] Emerging research suggests that this decline not only accelerates visible aging but also contributes to a cascade of metabolic and neurological issues, making NAD+ restoration a cornerstone of modern anti-aging protocols

However, results of some case-control studies (46-50) and controlled trials (51, 52) have suggested that periconceptional supplementation with a multivitamin containing folic acid may protect against congenital cardiovascular malformations, especially conotruncal (outflow tract) and ventricular septal defects