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Autoimmune hypophysitis or elevated TNF- levels could suppress ACTH secretion in the pituitary and, together with chronic exposure to IL-10, TGF-1 and TNF- and hyperinsulinemia could also suppress ACTH-stimulated cortisol secretion in the adrenal gland (43, 44, 163169)

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What's Happening: NAD+ restoration begins affecting mitochondrial function