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Higher NAD+ activates the sirtuin family of NAD+-dependent deacetylases, particularly SIRT1, which deacetylates PGC-1alpha (promoting mitochondrial biogenesis), FOXO transcription factors (enhancing stress resistance), and NF-kappaB (reducing inflammation)

Observed in pilot human work A 2025 IV infusion pilot of BPC-157 in two adults at 10 mg and 20 mg reported no adverse effects on cardiac, hepatic, renal, thyroid, or glucose biomarkers (Lee et al., Alternative Therapies in Health and Medicine, 2025)

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