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While humans lack the nicotinamidase enzyme needed to convert NAM directly to NA, bacteria contain nicotinamidase and can deaminate NAM to NA.[2830] Gut microflora can also synthesize NAD from niacin and produce niacin equivalents from tryptophan.[3133] Niacin biosynthesis is present in the majority of the human gut microflora genomes: 63% of all investigated gut microflora genomes contained one or more NAD biosynthesis pathways.[33] Similar to other tissues, the gut also uses niacin equivalents for its needs

Common Uses Rybelsus can offer more benefits than just supporting the release of insulin

and muscle dysfunction, the main symptom of which is overall fatigability

It overlaps with both but isnt identical to either

Studies have shown faster recovery from Achilles tendon transection, improved healing after muscle tears, and even some evidence of gut mucosal repair in models of inflammatory bowel disease