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This symptom is usually the result of anemia, which can be caused by a lack of B-12

G.YeZ.BuijsseB.ArriolaL.BalkauB.et al (2012)

NAD+ is a vital component in this energy production process

Users stopping niacinamide typically experience very gradual benefit decline over 1-3 months without dramatic reversal, maintaining 40-60% of improvements long-term if treatment lasted 6+ months, and tolerating breaks or cycling without rebound effects or significant regression concerns

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In the future, new therapeutics based on various components of the GHIGF axis might be developed to further improve the treatment of such disorders