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What they found: Plasma NAD+ did not rise directly , it was rapidly metabolized Plasma nicotinamide and methyl-nicotinamide rose markedly , markers of NAD+ metabolism NAD+ likely reaches tissues as its metabolites (not as whole NAD+) Clinically, patients subjectively reported increased energy during and after the infusion No serious adverse events during the 6-hour IV infusion Why it matters: The study provides rare clinical data on IV NAD+ , the administration route used by NAD+ clinics off-label

However, this chemical process includes complex reaction processes and low yield, resulting in high cost and low purity of -EC, limiting the production of -EC for physical function investigations and medical/pharmaceutical applications

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Because of this, oral vitamin B12 is considered to be safe even at high doses