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In the case of ME/CFS, this energy strain may be a consequence of exertion-sensitive tissue hypoxia, leading to systemic patterns of metabolic adaptation and compensation (185)

Weltzler M, Thomas DA, Wang ES, Shepard R, Ford LA, Heffner TL, Parekh S, Andreeff M , O'Brien S, Kantarjian HM

You will find that there is a delay in the onset of a symptom from its cause

Whether caused by sports, workouts, or repetitive strain, healing is often slow and frustrating

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This action subsequently influences the metabolic process that needs NAD+
