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A vitamin B12 deficiency may be the cause

Side effects are common but usually manageable

Research and clinical experience suggest that IV NAD+ produces a sharp but short-lived spike in plasma levels that does not reliably translate to intracellular increases, which is where the therapeutic effect actually happens

This was because the drug did not significantly reduce weight in 536 subjects over the course of 24 weeks 2

Symptoms include persistent fatigue and low energy, brain fog and poor concentration, low mood, anxiety or depression, memory problems, tingling or numbness in hands and feet, poor sleep quality, weakened immune function and hair thinning and loss