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instead, they produce them daily in their rumen

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The FDAs own scientists were far more concrete with the committee than the evidence is thin. They flagged a real risk that synthetic versions of molecules your body already makes will provoke an immune response, up to and including anaphylaxis (a severe, potentially life-threatening allergic reaction)

Energy Regulation How cells respond to changes in energy demand and fuel availability

In D-galactose-induced aging mice, oral administration of the product significantly increased NAD+ levels in liver and adipose tissue, activated mitochondrial energy metabolism pathways, improved insulin sensitivity, lowered blood glucose and lipid levels, reduced visceral fat accumulation, and increased energy expenditure, alleviating fatigue and abnormal body weight associated with aging

Depending on the level (cervical, thoracic, lumbar), this causes radicular pain, numbness, weakness, or combination symptoms