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While there are no formal quality criteria for BV due to its classification outside the regulatory frameworks for medications and food products, researchers have suggested using quantitative analysis of stable components and comprehensive characterization as indirect means of assessing the purity and quality of BV

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NAD levels naturally decline with age and can also be reduced by stress, illness, poor sleep, intense exercise, and inadequate nutrition, which may contribute to fatigue, cognitive changes, and reduced resilience

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