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Vitamin B3 is part of many important coenzymes and significantly contributes to optimal energy metabolism, supports the nervous system, and reduces fatigue and exhaustion

It can also be caused by autoimmune diseases, like alopecia areata

doi: 10.1146/annurev.phyto.050908.135202 71 WangS

Similarly, patients with conflicting data on the key criteria of fatigue, unrefreshing sleep, and postexertional malaise, who could not be dependably identified from documentation thereafter, were excluded (13, 17, and 55 patients, respectively)

used capillary electrophoresis-dual diode array detection and tandem mass spectrometry (CE-UV-MS/MS) for human urinary cardiovascular biomarkers such as L-carnitine (Cieslarova et al., 2019)