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Or does this just drive up healthcare spending with unclear long-term savings

Conclusions L-carnitine supplementation may offer cardioprotective benefits in CAD patients

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According to a 1961 study, patients with addiction who got NAD+ at a moderate IV drip rate (no more than 35 drops per minute) reported "no distress" but those who received it at a quicker drip rate complained of headache and shortness of breath (18)

Indeed, phenformin, an NADH:ubiquinone oxidoreductase inhibitor, suppressed SARS-CoV-2 and dengue virus replication

Talk to Your Healthcare Provider If fatigue persists or worsens, your healthcare professional may recommend dose adjustments, laboratory testing for nutrient deficiencies, or investigation into other health conditions that may be contributing