Sirtuins, poly(ADP-ribose) polymerases and the CD38/CD157 ectoenzymes cleave the glycosidic bond between the nicotinamide and the ADP-ribosyl moiety, releasing nicotinamide stoichiometrically, so NAD+ is destroyed rather than recycled and must be resynthesised through the NAMPT-limited salvage pathway (Cant, Menzies and Auwerx, Cell Metabolism, 2015)
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Lifestyle and dietary interventions for Mnire's disease
Because vitamin B12 amplifies the effectiveness of NAD+, particularly in patients with fatigue, mood instability, or low blood levels of B12