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The first one is synthesized through three steps, starting with the conversion of nicotinic acid into NAD, utilizing nicotinic acid mononucleotide and nicotinic acid adenine dinucleotide, while the second one is achieved by the action of enzyme NAD+ kinase, which phosphorylates NAD (3, 13, 14)

Heruye, S.H., Nkenyi, L.N.M., Singh, N.U., Yalzadeh, D., Ngele, K.K., Njie-Mbye, Y., Ohia, S.E., and Opere, C.A., Current Trends in the Pharmacotherapy of Cataracts

Clinical data confirms this efficiency difference, which is why BiCarb ARC achieves the same performance-critical blood bicarbonate level with a meaningfully lower total dose

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