This new work with NAD Therapy is very exciting and I think is right on target. It is indeed an energy-metabolic-deficiency (EMD) because in the absence of this coenzyme cycle almost all the reactions in the body run down... I congratulate Theo Verwey and his colleagues for this remarkable advance in using this concept and in using a simple test, the ratio of pyruvate to lactate as a diagnostic measure, to indicate the dose, duration of treatment etc.