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Boosting NAD levels has been shown to improve ATP synthesis, which has several benefits including: Improving your bodys ability to convert the food you eat into usable energy Promoting overall cellular function Optimizing energy production that affects how efficiently you burn through your energy stores Unlike stimulants, which activate the nervous system and may lead to crashes, NAD+ prescriptions like Midi's NAD+ Nasal Spray work at the cellular level where energy is created

But the key word is slowly

Short-term improvement of erectile dysfunction by viewing humorous films in patients with atopic dermatitis

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Prostaglandins Leukot Essent Fatty Acids 67:3338 Torrioli MG, Vernacotola S, Peruzzi L, Tabolacci E, Mila M, Militerni R, Musumeci S, Ramos FJ, Frontera M, Sorge G, Marzullo E, Romeo G, Vallee L, Veneselli E, Cocchi E, Garbarino E, Moscato U, Chiurazzi P, DIddio S, Calvani M, Neri G (2008) A double-blind, parallel, multicenter comparison of L-acetylcarnitine with placebo on the attention deficit hyperactivity disorder in fragile X syndrome boys

Heres what the evidence really shows for astaxanthin's effects on skin