I've had real problems with what I believe to be an arthritic knee for over a year - I assume it had just worsened with time but now I see that it has coincided with starting PT (and NR) - my knee has been much better the last few months and I've greatly reduced PT by coincidence; however, just lately I've started to increase it again and have moderate discomfort. Obviously I'm not highly confident it is PT yet, the peak of my knee inflammation coincided with several weeks of very challenging walking but also very high doses of NR+PT, so it was easy to overlook supplements as a cause, but it should be easy to be ascertain at some point (I've also experienced no other joint pain). I've been ramping up NR again and have noticed the sole of my feet pain I first experienced when taking NR, but perhaps it was the PT. Incidentally, I've been taking NR intermittently with N+R for several weeks but not noticed the joint or sole pain til lately, though NR dosing has increased. So perhaps we could see if there is correlation with PT and the joint pains experienced.
A number of people on the NR personal experience thread have reported joint pain--and appear to associate it with NR.
When I look at the pathways involved, nampt is the enzyme that converts nicotinamide to NMN.
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If you are successful in upping your NAD+, you will generate NADP, and the NADP will be converted into a number of subsidiary chemicals--including nicotinamide (the so-called 'salvage pathway').[See attached diagram.}
This could easily lead to higher nampt production in at least some people, and greater inflammation. Too much NAD+ on a continual basis might have consequences, even without pterostilberine.
One of the nice things about Turnbuckle's protocol is that it is cyclic, rather than simply swamping the body with the same supplement day-after-day.
You make a good point. The first time I tried fission/exercise I did it 4 days straight and subsequently felt beat up for a week--which included knee and ankle pain. As I wasn't using resveratrol at the time, nampt could have been the source of that. So a nampt inhibitor might be even more useful than fusion.