NAD+ levels can drop by more than 50% as we age from 40 to 60. This sharp decline creates problems like low energy, poor recovery and a higher chance of age-related diseases. NAD+ plays a key role in over 500 enzyme reactions, which makes it one of the body's most important compounds.
Many people ask if NAD and NMN are identical molecules. They're not the same, though they work together closely. NMN acts as a building block to create NAD+, and taking it as a supplement can boost NAD+ in your body. Both molecules have caught researchers' attention in the field of longevity science. To cite an instance, research points to NMN's benefits for muscle strength, blood sugar control and cell energy production. Scientists still debate which option works better to slow down aging.
NAD+ levels drop by half about every 20 years. This decline speeds up the aging process and damages DNA stability. The choice between NMN or NAD+ supplements grows more crucial each year. This piece gets into the science behind both supplements to help you pick the right one to support healthy aging in 2025 and beyond.
Understanding the NAD+ Decline with Age
"As we age, however, our natural NAD levels decline, which can contribute to fatigue, slower metabolism, and other age-related health issues." — Dr. Leonard Guarente, Professor of Biology at MIT and pioneer in aging research
Nicotinamide adenine dinucleotide (NAD+) is a vital coenzyme found in every living cell. It takes part in over 500 metabolic reactions that keep us alive. NAD+ levels drop in a predictable way as we age, which affects our cells' health directly.
How NAD+ levels drop over decades
Studies show that NAD+ levels consistently decrease with age in humans, mice, and worms. This drop happens in almost all tissues and follows a clear pattern. People in their middle age typically have only half the NAD+ levels of their younger years [1]. The decline doesn't stop there. By age 60, some tissues show up to 80% less NAD+ compared to young adults [2].
Different tissues lose NAD+ at different rates. Human skin loses at least 50% of its NAD+ through adult aging [3]. Brain tissue shows a 10-25% drop from young adulthood to old age [3]. The liver's NAD+ levels in people over 60 are about 30% lower than those under 45 [3].
Men and women experience this decline differently. Research shows that men's NAD+ levels drop faster, especially during middle age [2]. Several factors speed up this natural decline. These include high-fat diets, lack of exercise, too much alcohol, and immune system challenges [4].
Consequences for energy and repair
Lower NAD+ levels affect nearly every part of how cells work. Since NAD+ is crucial for metabolism, its decline disrupts many key processes:
- Energy production failures: Less NAD+ hurts mitochondrial function. This reduces oxygen use and energy production [5]. People feel more tired and can't do as much physically.
- Impaired DNA repair: Lower NAD+ weakens PARP activity, which we need to fix DNA. This leads to more genetic mistakes and mutations [4].
- Metabolic dysregulation: When NAD+ drops, glucose metabolism and insulin sensitivity suffer. This can cause metabolic disorders [6].
- Cellular communication breakdown: Low NAD+ creates a "pseudohypoxic state" that disrupts how nuclei and mitochondria talk to each other [7]. Cells act like they're starved of oxygen even when oxygen levels are normal.
- Increased inflammation: Less NAD+ turns on inflammatory pathways that contribute to "inflammaging" - the ongoing low-level inflammation we see in aging [8].
These changes create a dangerous loop. As NAD+ drops, cells become senescent and trigger inflammation. This activates CD38 (which uses up NAD+), making levels drop even faster [2].
Why boosting NAD+ is a longevity focus
NAD+'s key role in aging makes it a prime target to extend healthspan. Its decline affects many aspects of aging at once, so bringing levels back up could be a powerful way to stay healthy longer.
Studies show that boosting NAD+ levels through precursors can slow or even reverse some aging signs. When mice get more NAD+, their mitochondria work better, stem cells become more active, insulin sensitivity improves, and some even live longer [1].
NAD+ restoration helps with many age-related problems at once instead of treating single symptoms. This includes better heart function, brain health, and metabolism [6].
The choice between NAD and NMN becomes important here. Direct NAD+ supplements don't get into cells well. That's why precursors like NMN work better to boost cellular NAD+ levels [4]. This explains why discussions about NMN vs NAD+ focus on which one raises NAD+ levels inside cells more effectively.
Both NMN and NAD+ share the same goal - fighting the age-related NAD+ decline that weakens how cells work throughout the body.
NMN vs NAD+: Which Is More Bioavailable?
"While direct NAD supplementation is not an option due to its large molecular size and poor absorption, NMN and its counterpart, Nicotinamide Riboside (NR), serve as efficient precursors that the body readily converts into NAD." — Dr. Charles Brenner, Roy J. Carver Chair and Head of Biochemistry at the University of Iowa
The bioavailability difference between NMN and NAD+ plays a key role in choosing the right supplement to curb age-related NAD+ decline. The amount of a substance that enters your bloodstream after consumption determines how well these molecules can restore NAD+ levels in aging tissues.
Oral absorption rates
NMN's oral absorption profile shows quick uptake. Studies in mice reveal plasma NMN levels rise sharply within 2.5 minutes after oral gavage. The levels continue to increase between 5-10 minutes before going back to normal at about 15 minutes [4]. This quick absorption points to good uptake in the gut. The liver's NAD+ levels show steady increases from 15-30 minutes after taking NMN [4], which proves that oral NMN quickly turns into NAD+ in major metabolic tissues.
NAD+ faces big challenges with oral absorption. Its large molecular size and unstable nature mean NAD+ breaks down easily in the digestive system, making it unsuitable as an oral supplement [9]. This major limitation is why doctors give NAD+ through IV instead of oral supplements.
Studies using specially marked NMN (C13-D-NMN) further prove its better oral absorption. Scientists found this marked NMN in liver and soleus muscle tissues right after giving it to test subjects [4]. Research also shows that NMN stays stable in water, with 93-99% staying intact at room temperature for 7-10 days [4].
IV vs capsule vs powder
The way these molecules reach your cells depends a lot on how you take them. IV NAD+ goes straight into your bloodstream without going through digestion [10]. You'll notice effects on energy, mental clarity, and cell function within hours [10].
NMN capsules need to go through your digestive system first, which takes longer to work if you have a slower metabolism [10]. Still, research proves that NMN capsules raise blood NAD+ levels effectively [9]. Scientists found an interesting limit - 600mg of NMN in capsules raises blood NAD+ levels, but 900mg doesn't increase them any further [9].
NMN powder mixed in water works well too. Research shows mice drinking NMN-enriched water have higher blood NAD+ levels [9]. NMN stays stable in stomach acid [9], so powder might work just as well as capsules without needing special coatings.
Why NMN is easier to absorb
Finding the Slc12a8 transporter explains why NMN works better. This special transporter in your small intestine moves NMN directly into cells [11]. Mice with reduced Slc12a8 in their gut showed much lower NMN uptake, proving this transporter's vital role [11].
Scientists used to think NMN had to change into nicotinamide riboside (NR) before cells could use it. New research says otherwise. Mouse liver cells take in NMN directly - about 30% of their normal NMN amount within an hour - using Slc12a8 [11].
NMN and NAD+'s different molecular structures explain why they work differently. NAD+ is too big and unstable to cross cell walls intact. NMN's medium size and stability let it move from gut to cells, where it becomes NAD+ [5].
These key differences explain why most experts now recommend NMN for oral supplements, even though both molecules aim to raise cellular NAD+ levels to fight aging effects.
How NMN Works to Boost NAD+ Naturally
NMN's role in boosting NAD+ becomes clear when we look at its unique molecular pathway. The connection between nicotinamide mononucleotide (NMN) and nicotinamide adenine dinucleotide (NAD+) shows why researchers prefer NMN as a supplement to boost cellular NAD+ levels.
One-step conversion process
NMN stands out in the NAD+ biosynthesis pathway as the final precursor before NAD+ itself. Cells convert NMN to NAD+ in one simple step through the enzyme NMN adenylyltransferase (NMNAT) [2]. This direct pathway gives NMN a clear advantage in the nmn vs nad+ discussion.
NMN's molecular structure has a nicotinamide riboside (NR) molecule bonded to a phosphate group [12]. This structure puts it just one enzymatic step away from NAD+, making it the quickest way to synthesize NAD+. Yes, it is this proximity in the metabolic pathway that leads researchers to describe NMN as "one step closer" to NAD+ than other precursors [13].
The body's tissues process this conversion differently. NMNAT enzyme comes in multiple forms throughout the body, each with its own efficiency in turning NMN into NAD+ [3]. This explains why some tissues prefer certain NAD+ precursors.
Speed and efficiency of NMN uptake
Studies show NMN absorbs and converts quickly. Mice given oral NMN show it reaches the bloodstream within 2-3 minutes and appears in tissues within 15 minutes [2]. The liver's NAD+ levels rise within 15-30 minutes after taking NMN [12].
Scientists found the Slc12a8 transporter, which changed our understanding of NMN uptake. This specialized transporter lives mainly in the small intestine and moves NMN straight across cell membranes into the cytoplasm [4]. The small intestine's Slc12a8 levels are about 100 times higher than in brain or fat tissue, which explains oral NMN supplement's efficiency [4].
Before this finding, scientists thought NMN had to become NR before entering cells. While this indirect path exists—NMN turns into NR through CD73, enters cells via equilibrative nucleoside transporters (ENTs), then becomes NMN again through NR kinases (NRKs)—new evidence shows direct NMN transport through Slc12a8 works faster [2].
This two-path system provides backup options that change based on tissue type and body conditions. Studies prove that NMN still raises NAD+ levels even when NRK1 (needed for the indirect path) stops working, showing how important direct transport is [14].
Comparison with other precursors like NR
NMN and nicotinamide riboside (NR) lead the pack as NAD+ precursors, but they work differently. NR must become NMN before turning into NAD+, while NMN is already closer to the final form [13]. This difference affects how well they work in various tissues.
NR needs NR kinases (NRKs) to transform into NMN before becoming NAD+ [15]. Then, tissues with less NRK might get better results from direct NMN supplements. On top of that, NMN stays more stable in water than NR, which helps when making supplements [2].
These precursors interact differently in various tissues. To cite an instance, liver cells can't take in NMN directly—it must first become NR [13]. This behavior in specific tissues shows why "is NAD and NMN the same" needs a deep grasp of cell metabolism.
A newer study, published in 2023 proves NMN works. This randomized, double-blind research found that daily NMN supplementation (300-900 mg) substantially increased blood NAD+ levels after 30 and 60 days versus placebo [16]. Blood NAD+ levels peaked in groups taking 600 mg and 900 mg NMN [16], showing higher doses work better.
These mechanisms explain why NMN leads the way in strategies to boost NAD+ and fight age-related decline.
Comparing Benefits: NMN or NAD+ for Longevity
Research shows clear advantages of these compounds in many health areas. NAD and NMN's differences become especially important when you look at how they affect age-related decline in body systems of all types.
Cognitive and neurological support
NMN and NAD+ both protect neurons, but NMN shows better results in Alzheimer's disease models. Studies show that NMN administration substantially improves cognition and memory in mouse models of Alzheimer's disease [17]. These improvements happen through several ways:
- It reduces neuronal death by about 65% in brain regions affected by Alzheimer's disease [6]
- It boosts mitochondrial metabolism in neurons to improve energy production [17]
- It lowers reactive oxygen species that damage neurons [17]
- It helps maintain blood-brain barrier integrity [4]
NMN works better in older subjects - aged mice respond more favorably to NMN treatment than younger ones [18]. NAD+ administration also rescues cognitive deficits and stops neuroinflammation by protecting mitochondria in models of chronic cerebral hypoperfusion [19].
Heart and vascular health
Scientists have well documented NMN's cardiovascular benefits. NMN protects the mouse heart from ischemia and reperfusion injury [4]. On top of that, it shows lasting vascular benefits:
-
It improves blood flow and boosts capillary density in aged mice [20]
-
It boosts endothelium-dependent vasodilation [7]
-
It reduces arterial stiffness by lowering oxidative stress [21]
NMN injection raises baseline NAD+ levels in the heart and prevents decline during ischemia [7]. This heart protection works mainly through SIRT1 activation, as SIRT1 knockout mice don't show these benefits [7].
Metabolic and insulin sensitivity
The strongest human evidence for NMN's benefits comes from a 10-week randomized, placebo-controlled, double-blind trial in postmenopausal women with prediabetes. This breakthrough study found:
NMN supplements increased insulin-stimulated glucose disposal by 25% [22] They boosted skeletal muscle insulin signaling through increased phosphorylation of AKT and mTOR [22] They raised expression of muscle remodeling genes [22]
NMN improved insulin action and secretion in mice bred to be diabetic or obese [4]. Unlike animal studies where NMN supplements raise NAD+ levels, the human trial showed no change in steady-state muscle NAD+ levels. This suggests NMN might increase NAD+ turnover instead of static concentrations [22].
Muscle and mitochondrial function
Both compounds help muscle health through different ways. NMN has brought back skeletal muscle in aged mice [4] and slowed cognitive decline in Alzheimer's disease models by helping neurons survive [4].
For physical performance, NMN supplements boost aerobic capacity in humans. Higher doses of 1,200mg showed better results than 300mg doses [23]. NMN also boosts mitochondrial function in metabolic organs like skeletal muscle, liver, and heart [18].
Current evidence suggests NMN might work better than NAD+ because it's more bioavailable and converts directly to NAD+.
Which Supplement Is More Practical for Daily Use?
People choose supplements based on practical reasons as much as scientific evidence. Several practical factors come into play when choosing between NAD+ and NMN supplements.
Cost and availability
NMN costs less than NAD+ therapies. NMN supplements in capsule form cost between $1.33-$6.35 per gram [24]. IV NAD+ treatments, on the other hand, can set you back anywhere from $370 for a simple protocol to $2,800 for a five-session therapy [1]. This big price difference makes NMN a better choice for daily use.
The market tells an interesting story too. Before regulatory changes, NMN led the anti-aging supplement market with nearly 300 different brands available on Amazon alone, while NAD+ had about 40 brands [8]. The scene changed in November 2022 when the FDA banned β-NMN as a dietary supplement [8]. This happened because a company started researching NMN as a potential drug, which meant it could no longer be sold as a supplement under federal rules.
Ease of use and dosing
These supplements differ in how you take them:
NAD+ comes as:
-
Intravenous (IV) therapy that needs medical supervision
-
Subcutaneous injections
-
Oral supplements (with limited bioavailability)
-
Nasal sprays [25]
NMN is simpler with:
-
Oral capsules or tablets
-
Sublingual powders or liquids
-
Powdered drink mixes [26]
NMN dosage usually starts at 100-250mg daily [25], and clinical studies show benefits at 250-900mg daily [23]. Neither supplement has standard recommended doses, so it's vital to talk to healthcare providers for personal advice.
NMN shows better stability characteristics. It stays stable during digestion, while NAD+ breaks down quickly in the gastrointestinal tract [27]. This explains why oral NAD+ supplements don't work as well as NMN.
Clinical vs at-home use
Healthcare professionals must give NAD+ therapies, especially IV treatments, in clinical settings [25]. This adds inconvenience and extra costs beyond the supplement price.
NMN fits easily into daily routines at home. You can take it orally without clinic visits [28]. Some companies sell NAD+ home injection kits for about $350 for 20 doses [1], but these still need self-injection instead of simple oral intake.
NMN has fewer practical hurdles for daily use in terms of cost, availability, and ease of use. These factors matter just as much as effectiveness when choosing between these NAD+-boosting options.
Risks, Side Effects, and Who Should Be Cautious
Safety plays a crucial role in comparing NAD+ and NMN supplements. These natural compounds come with potential risks that change based on how you take them, the dose, and your health condition.
Mild digestive issues with NMN
NMN works well for most people, but some users face mild side effects at the time they start taking it. The biggest problem users report involves digestive discomfort. You might experience bloating, nausea, and stomach upset when you first begin NMN [5]. Some people get diarrhea, especially if they take it without food [5].
A small number of users deal with headaches, fatigue, and dizziness. These symptoms usually go away as their body gets used to the supplement [5]. Research backs up NMN's safety record. Studies show that up to 1,250 mg daily for 4 weeks caused no harmful effects in healthy men and women [29].
IV-related risks with NAD+
NAD+ therapy through IV comes with its own set of risks beyond regular supplements. Users might feel temporary flushing, dizziness, nausea, and headaches during or right after the treatment [30]. These effects usually clear up on their own.
The more serious risks show up where the IV needle goes in - things like infections, bruising, and irritation [30]. While rare, allergic reactions can show up as rashes, itching, swelling, or breathing problems [30]. On top of that, about 70% of people getting NAD+ IV therapy see a 3-10 fold increase in high-sensitivity C-reactive protein (hs-CRP). This increase that indicates possible inflammation [31].
Interactions with medications
These supplements need careful handling when mixed with certain medicines. NAD+ supplements might mess with diabetes medications like insulin and metformin, which could affect your blood sugar levels [32]. High doses of NAD+ supplements (over 2 grams daily) can make blood pressure medications work too well, leading to dangerous drops in blood pressure [32].
Blood thinners need special attention because NMN might affect blood flow and how your vessels work [33]. NAD+ boosters like niacin can also change how anticoagulants such as warfarin work in your body [32].
All but one of these groups should stay away from these supplements: pregnant women, nursing mothers, people with liver or kidney disease, and those with specific allergies [34]. Cancer patients need to be extra careful since studies hint that NAD+ might help cancer cells grow or make cancer treatments less effective [32].
Make sure to check with your doctor before starting either supplement, particularly if you take prescription medications or have existing health conditions.
Choosing the Right Product: What to Look For
Choosing the right NAD+ boosters needs careful attention because product quality varies wildly in the market. The latest market analysis shows some alarming findings about the difference between what's on the label and what's actually inside these products. This makes your product selection crucial to get the results you want.
Purity and third-party testing
Quality control is one of the biggest problems in the supplement industry. A commercial study by ChromaDex revealed something shocking - 14 out of 22 NMN products they tested (64%) had less than 1% of the NMN content they claimed. Some products didn't have any detectable NMN at all [35]. Another study showed the actual amounts ranged from 28.6% more to completely missing [36].
You should look for products that come with a Certificate of Analysis (COA) from independent labs. The best supplements usually provide:
-
Proof of 99% or higher purity [37]
-
Complete impurity profiles
-
Heavy metal and microbial testing results
-
Batch identification information
High-performance liquid chromatography (HPLC) testing stands out as the best way to check NMN concentration and purity [10]. The most reliable manufacturers share their test results through QR codes on packaging or their websites.
Formulation and delivery method
Capsules are the only NMN delivery system that researchers have thoroughly tested in human clinical trials [9]. Other options include:
-
Sublingual powders or tablets
-
Nasal sprays
-
Topical creams
-
Liposomal formulations
Companies claim these alternative delivery methods improve absorption. However, science backs oral supplements as the most effective option [38]. Scientists discovered an NMN-specific transporter in the small intestine, which suggests our gut knows how to absorb oral NMN efficiently [38].
NMN shows remarkable stability in water. It stays 93-99% intact at room temperature for 7-10 days [9]. This means both powder and capsule forms stay effective with proper storage.
Trusted brands and certifications
The best place to start is by finding supplements made in cGMP-certified facilities that follow strict FDA standards [10]. The most respected third-party certifications include:
-
NSF International certification
-
USP verification
-
ISO-certified laboratory testing
Quality products display these certification logos on their packaging or websites [10]. Watch out for unusually cheap products. Making pharmaceutical-grade NMN costs a lot, so prices under £0.40 per gram should raise red flags about possible counterfeits [10].
The best manufacturers are open about their ingredient sources, synthesis methods, and quality control processes. This transparency helps you make smart buying decisions.
Is NAD and NMN the Same? Can You Use Both?
The key difference between NAD+ and NMN explains why longevity researchers explore both compounds. These closely related substances play unique roles that help us understand the best ways to supplement them.
Clarifying the relationship
NAD+ and NMN are different compounds that work together in the same metabolic pathway. They share chemical features but each has its own biological role. NMN (nicotinamide mononucleotide) changes into NAD+ inside cells through a single enzyme step [39]. This makes NMN the final building block needed to create NAD+ [4]. NAD+ then works as an active coenzyme that helps hundreds of metabolic reactions throughout the body.
These compounds depend on each other - you can't have one without the other [40]. NMN gives cells the raw material they need to make NAD+. This creates a biological partnership rather than a competition between alternatives.
When combining makes sense
Taking both supplements together can give complementary benefits in some cases. The combination provides both immediate availability and sustained production of NAD+ [11]. Different body tissues have varying priorities for NAD+ precursors [41].
This two-pronged approach works great if you have comprehensive coverage needs. NMN enters cells easily through special transporters (Slc12a8) and will give a steady NAD+ supply [4]. Direct NAD+ supplements might boost circulating levels when your body needs more energy [11]. Research shows that combining NMN with compounds like resveratrol leads to higher NAD+ levels in heart and skeletal muscle than just taking NMN by itself [42].
What experts recommend
Prominent researchers now favor precursor supplements over direct NAD+. Harvard's David Sinclair and Washington University's Shin-ichiro Imai run human trials that focus on NMN instead of NAD+ [4]. Imai suggests NMN could improve adult human metabolism to match someone ten to twenty years younger [4].
The largest longitudinal study confirms NMN's safety, with oral doses up to 300 mg/kg proving safe in mice over one year [4]. Experts still emphasize the need to check with healthcare professionals before starting supplements since everyone responds differently [43].
Comparison Table
Attribute |
NAD+ |
NMN |
---|---|---|
Bioavailability |
Poor oral absorption; breaks down in gastrointestinal tract |
High oral absorption; reaches bloodstream within 2-3 minutes |
Administration Methods |
- IV therapy |
- Oral capsules/tablets |
Cost Range |
$370-$2,800 for IV treatments |
$1.33-$6.35 per gram (capsules) |
Main Benefits |
- Improves energy production |
- Improves muscle health |
Side Effects |
- Flushing |
- Mild digestive issues |
Cellular Transport |
Cannot efficiently cross cell membranes intact |
Direct cellular uptake via Slc12a8 transporter |
Practical Usage |
Requires clinical administration (for IV) |
Suitable for at-home use |
Stability |
Low stability; breaks down easily |
High stability (93-99% intact after 7-10 days in water) |
Conclusion
Scientific evidence clearly shows NMN works better than NAD for people who want to curb age-related NAD+ decline. NMN proves to be more available, practical and efficient compared to direct NAD+ supplements based on detailed analysis.
The research is clear - NMN enters your bloodstream faster, usually within minutes after taking it. This happens because of special Slc12a8 transporters in the small intestine. Your cells can absorb NMN easily, while NAD+ breaks down in your digestive system before reaching circulation. NMN also needs just one enzyme step to become NAD+ once it's inside your cells.
Clinical studies back up NMN's benefits in many biological systems. People who take NMN regularly show better insulin sensitivity, stronger muscles, and improved metabolic health. Animal studies reveal it might protect brain cells, boost heart function, and help mitochondria work better - everything in healthy aging depends on these factors.
The practical benefits of NMN are compelling. NMN costs between $1.33-$6.35 per gram, nowhere near the hundreds or thousands you'd pay for NAD+ IV treatments. This makes NMN available to more people who want to take it daily. You can take NMN pills at home instead of going to clinics for injections, and it works just as well.
Quality control problems are systemic in the supplement market, so buyers should be careful. The quickest way to ensure you're getting real, pure NMN is to look for third-party test results, cGMP certification, and open manufacturing processes. This helps avoid fake products that don't work.
Both compounds aim to increase cellular NAD+ levels, but evidence shows NMN offers a better path. NMN stands out as the top choice if you have age-related NAD+ decline and related health issues. You should still check with your doctor before starting supplements, especially with existing health conditions or if you take other medications.
FAQs
Q1. Is NMN more effective than NAD+ for anti-aging purposes? NMN is generally considered more effective due to its superior bioavailability and efficient conversion to NAD+ in cells. It's easier to absorb orally and shows promising results in improving various aspects of cellular health and metabolism.
Q2. What is the recommended dosage of NMN for anti-aging benefits? The typical recommended dosage of NMN ranges from 250 mg to 500 mg per day. Clinical studies have shown benefits at doses between 250-900 mg daily, but it's best to consult with a healthcare provider for personalized advice.
Q3. Can NMN supplementation actually reverse aging? While NMN can't completely reverse aging, studies show it can mitigate various age-related changes. Benefits include improved energy metabolism, enhanced insulin sensitivity, better mitochondrial function, and reduced age-associated weight gain.
Q4. How do NAD+ levels affect the aging process? NAD+ levels naturally decline with age, impacting cellular energy production, DNA repair, and overall cellular health. Restoring NAD+ levels through precursors like NMN may help slow certain aspects of cellular aging and improve metabolic function.
Q5. What are the potential side effects of NMN supplementation? Most people tolerate NMN well, but some may experience mild side effects, particularly when first starting supplementation. These can include digestive discomfort, headaches, and temporary fatigue. These effects typically subside as the body adjusts to the supplement.
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