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JACC Basic Transl Sci 5:63244

The 10-day window is intended to deliver a concentrated signaling effect to the cells involved in circadian regulation and renewal before the long rest allows those adaptations to consolidate

a form of vitamin B3 promoted as an anti-aging supplement), slows disease progression and improved primary outcomes [ALSFRS-R and forced vital capacity (FVC)] in ALS patients

Be aware that dose changes, including increases, are the most common trigger for this side effect

Most patients experience modest hunger increase during weeks 3-6 of the wean, which typically plateaus rather than continuing to spike