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He views this as part of comprehensive hormone optimization for a man in his fifties who wants to maintain peak performance

331 Notably, 12 months after splenectomy plus pericardial devascularization in chronic hepatitis B cirrhosis patients, gut flora composition restored to near healthy control levels, and liver function, intestinal permeability, and inflammation levels improved compared to pre-surgery, indicating that the improvement in liver function and intestinal permeability after splenectomy plus pericardial devascularization may be related to gut flora recovery

By blocking NNMT, it increases intracellular NAD+ levels, which in turn activates sirtuins (like SIRT1), leading to improved metabolism and reduced fat storage

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Additionally, rare deficiencies of glutathione cycle enzymes (gamma-glutamylcysteine ligase, glutathione synthetase, 5-oxoprolinase, and gamma-glutamyl transferase) have all been associated with neuropsychiatric and cognitive impairments, although detailed phenomenological characterization has not been reported (9, 61, 62)

Evidence for the presence of S-100 protein in the glial component of the human enteric nervous system