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The gut microbiota also plays a significant role in late-phase oral NR metabolism (3 h post-administration), which is converted to NAM by the enzyme BST1, and then deamidated into NA by microbes, allowing PreissHandler synthesis by capable tissues 127

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This reaction simultaneously depletes two critically important metabolic cofactors: SAM (the universal methyl donor for hundreds of epigenetic and biosynthetic reactions) and nicotinamide (the precursor for NAD+ biosynthesis via the salvage pathway)

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