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Diabetes Care 43, 446452
Academic Press
beta-oxidation runs at high capacity The same deficit lowers T3, which slows the Complex I step that regenerates NAD+ from NADH NADH builds up faster than it clears, and the NAD+/NADH ratio falls The low ratio quiets sirtuins and mimics a low-oxygen state in normal oxygen, a "pseudohypoxic" pattern Fat is mobilized but not cleanly converted to ATP: the wired-but-underpowered feeling, and progress stalls Competing demands for NAD+ The NAD+ pool serves four masters simultaneouslyand they all compete for the same finite resource: When energy production dominates the poolas it does during aggressive metabolic protocolsthe other systems get rationed
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