What Actually Causes IBD? A Mechanistic Reading of Crohn's Disease and Ulcerative Colitis — What restoration looks like

A treatment approach that addresses the bioenergetic lesion alongside the conventional medical management of IBD looks substantially different from standard care. The conventional medications remain appropriate for the inflammation. The bioenergetic work proceeds in parallel. The bioenergetic work, in rough sequence: First, identify and reduce the upstream drivers sustaining the inflammatory drive. This is patient-specific. For some it is dietary triggers (specifically food antigens crossing a compromised barrier). For some it is ongoing low-grade infection. For some it is environmental exposures, including mycotoxins. For some it is bidirectional vagal dysfunction described in the POTS article . The patient's specific drivers need to be identified through systematic case review. Second, restore the regulatory cofactor pool. NAD+ precursor supplementation (nicotinamide riboside or NMN at clinically validated doses, often combined with niacinamide as a baseline support) addresses the CD38-driven NAD+ depletion. Attention to methylation cofactors supports the broader cofactor environment. B vitamins in their functional forms. Magnesium glycinate. The cofactor work is foundational because without it the cell cannot perform the work the other interventions require. Third, work the colonocyte substrate directly. This includes addressing the SLC5A8 silencing where possible (through r