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Involved in cellular signaling and regulating calcium levels, CD38 degrades NAD + , using it as a co-substrate for its enzymatic activity 135,136

[6] [25] At levels only slightly below normal, deficiency can result in fatigue, headaches, feeling faint, rapid breathing, pale skin, numbness or tingling, poor appetite, heartburn, poor balance, difficulty walking, poor reflexes, blurred vision, memory problems, depression, irritability, inattention, cognitive decline, dementia, and even psychosis

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Retinal and optic nerve head ischemic disorders and atherosclerosis: Role of serotonin