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The Clinical Takeaway: It Is Rarely Either/Or The MOTS-c vs NAD+ question is most useful as a starting point for understanding which mechanism is more relevant to a patients current symptoms

However, with chronic exposure, the body may begin to blunt its pulsatility

These observations are consistent with a crossover study in 20 adults reporting significantly higher fasting plasma TMAO in participants above median age (45.5 years) (56)

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