Patients should not undergo NAD+ therapy if they have:

-A history of any active or recent (within five years) malignancies, particularly hormone-

sensitive cancers such as breast, ovarian, prostate, or testicular cancer

-Uncontrolled hypertension or cardiovascular disease

-Severe liver or kidney disease

-A known allergy to NAD+ or any ingredients in the infusion

-A history of severe reactions to intravenous infusions

Some side effects of NAD therapy include:

While NAD+ therapy is generally well-tolerated, potential risks and side effects may include:

- Flushing, warmth, or sweating during infusion

- Nausea, dizziness, or lightheadedness

- Headache or mild discomfort at the injection site

- Possible blood pressure fluctuations

- Risk of allergic reaction (rare)

- Temporary discomfort or cramping due to infusion speed

In rare cases, IV therapy may cause vein irritation, infection, or clot formation. Patients with

preexisting medical conditions should discuss potential risks with their provider.

ADVERSE EVENTS:

1. Accumulation of Toxic Metabolites: High doses of NAD+ precursors, such as

nicotinamide (NAM), can lead to the accumulation of toxic metabolites like

methylnicotinamide. This metabolite has been implicated in various diseases and

conditions, including liver damage and insulin resistance.

2. Tumorigenesis: There is a theoretical risk that increasing NAD+ levels could promote

tumorigenesis. This is due to the role of NAD+ in supporting cellular metabolism and

DNA repair, which could potentially aid the survival and proliferation of cancer cells.

However, this has not been conclusively demonstrated in human studies.

3. Cellular Senescence: Elevated NAD+ levels may promote cellular senescence, a state of

permanent cell cycle arrest that can contribute to tissue dysfunction and aging. This is

particularly concerning in the context of chronic high-dose NAD+ precursor

supplementation.

4. Mitochondrial Dysfunction: High doses of NAD+ precursors, such as nicotinamide

riboside (NR) and nicotinamide mononucleotide (NMN), have been shown to cause

mitochondrial dysfunction and oxidative stress in certain cell types. This can lead to

cytotoxicity, particularly in cells with high metabolic activity, such as hepatocytes.

5. General Side Effects: Common side effects reported in clinical trials include muscle

pain, nervous disorders, fatigue, sleep disturbances, and headaches. These side effects are

generally mild and do not pose a serious risk to health.

6. Epigenetic Alterations: Chronic high-dose administration of NAD+ precursors can alter

cellular methyl metabolism, affecting DNA and protein methylation. This can lead to

changes in the cellular transcriptome and proteome, potentially impacting gene

expression and cellular function.