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In addition to enzymatic L-lactylation utilizing lactate as a lactyl donor and involving enzymes including writers (lactyltransferases), readers (lactylation-binding enzymes), erasers (delactylases), and lactyl-coenzyme A (lactyl-CoA) synthases, non-enzymatic D-lactylation derived from the glyoxalase II substrate S-D-lactoylglutathione (SLG) has also been identified

As we get older, NAD+ levels may naturally decline, which can be associated with fatigue, brain fog, slower recovery, and decreased overall vitality

The classic example is active acromegaly, but prolonged high dose s.c