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The above considerations suggest that two pharmacologically distinct mechanisms with opposite effects on the same signaling pathway are involved in a normally unresolvable physiological failure (complete obstruction (ligation) of vessels and ischemia due to a cause that could be not removed, inadequate rescue and unable to heal)

Advanced research protocols also track NAD+ levels via blood assay, respiratory exchange ratio (RER) during exercise to measure substrate utilization, and adiponectin levels as a marker of metabolic health