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The metabolism and elimination of NAD+ (and its by-products) could be altered in advanced hepatic or renal dysfunction, and high-dose NAD+ might theoretically affect cardiovascular dynamics, so practitioners generally avoid or closely supervise NAD+ use in such settings
The good ones do
10.1038/s41409-021-01233-w 179
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Eventually this lead me to gain 10lbs, which isnt a lot but I didnt feel as good about my body
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