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This vasorelaxation is mediated through actions on purinergic receptors, specifically adenosine receptors ( + regulates the activity of NADPH oxidase, a significant ROS source in vascular cells, thereby playing a key role in the modulation of vascular tone (Reid et al., 2018)

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Inhibition of NNMT rebalances cellular methyl economy and NAD salvage flux, with downstream effects on adipocyte energetics, lipid handling, and insulin action observed in preclinical systems [13]

If your fatigue doesnt improve with lifestyle adjustments to your sleep, nutrition, and hydrationespecially if youre past 4 weeks of taking the medicationthen talk with a healthcare professional, like a Midi clinician