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NAD+ operates across several distinct and complementary cellular mechanisms, making it unique among research compounds in its breadth of biological relevance: Redox Metabolism: NAD+ acts as a hydride-accepting electron carrier in central metabolic pathways glycolysis, the Krebs cycle, beta-oxidation of fatty acids, and the mitochondrial electron transport chain

Drug families known to disrupt HPG axis signaling and/or decrease fertility by other mechanisms include 23 : Chemotherapy drugs (such as cisplatin, doxorubicin (Adriamycin, among others), 5-fluorouricil (5-FU), cyclophosphamide) 52 Psychiatric medications 23 Corticosteroids and other immune suppressants 23,69 Some blood pressure-lowering drugs including calcium channel blockers, angiotensin receptor blockers (ARBs), and angiotensin-converting enzyme inhibitors (ACEi)

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Major histocompatibility complex susceptibility genes, including HLA-DR3, HLA-DR4, HLA-DQ2, and HLA-DQ8, are shared by both diseases