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It is then tempting to speculate that in those critically ill patients with the worst outcomes (death or chronicity) an early pro-inflammatory stage could result in decreases in cellular NAD + and a subsequent failure of SIRT3 to prevent LCAD and glycolytic enzyme hyperacetylationthis would not only result in impaired fatty acid oxidation and subsequent cellular lipid accumulation, but also the acetylation of numerous mitochondrial proteins and glycolytic enzymes with subsequent immunoparesis and chronic organ dysfunction, as seen in sepsis and CKD (177, 190, 193, 253, 263)

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I did notice a mild increase in energy particularly in the morning wake up and some fat burning around my waist/abdominal area