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Too much NNMT can lower NAD+ levels (low NAD+ levels may make it harder to burn fat efficiently or maintain metabolic health as you age)

[8] Similarly, patients with gout or hyperuricemia should avoid high niacin intake, as niacin (even in nicotinamide form) can raise uric acid levels and potentially trigger gout flares

No IGF-1 elevation: HGH increases insulin-like growth factor 1 (IGF-1), which promotes growth of all tissues - including potentially problematic growth