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Importantly, environmental factors, such as exposure to toxicants (pollution, cigarette smoke), also play a large role here

417 Similarly, Yao et al

The phosphorylated form of NAD + , NADP/NADPH, parallels NAD + /NADH by functioning as a redox coenzyme in the pentose phosphate pathway, generation of acetyl coenzyme A (acetyl-CoA) for lipid and cholesterol biosynthesis, and in the glutathione and thioredoxin antioxidant systems 4,5,8,9

Maenner, M.J., et al

Therapeutic implications: Antioxidants and stress-reduction therapy may assist in combating neurogenic causes

it can be falsely negative in patients who are actively hemolysing