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NAD + can be generated de novo in the kynurenine pathway, where Trp is oxygenated to N-formylkynurenine by tryptophan 2,3-dioxygenase (TDO) or indoleamine 2,3-dioxygenase (IDO) 31

Both technologies eliminate daily dosing facilitated by their subcutaneous placement, which avoids first-pass metabolism and gastrointestinal degradation

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However, heres where it gets interesting: this reduction was actually associated with decreased pro-inflammatory Th17 cells in intestinal and visceral fat tissue, suggesting it may be part of how keto reduces inflammation