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As well if you have any chronic diseases and taking other drugs

Increased P85alpha is a potent negative regulator of skeletal muscle insulin signaling and induces in vivo insulin resistance associated with growth hormone excess

This restoration of metabolic cofactor availability enables enhanced function of NAD+-dependent enzymes including sirtuins, poly(ADP-ribose) polymerases, and various deacetylases that regulate cellular metabolism, stress responses, and aging processes

If symptoms are severe enough to disrupt daily function, reduce the dose to 2550mg for 57 days, then re-escalate slowly

On the other hand, too much B12 in your body can also give you vitiligo, mouth ulcers, eczema, and acne

NAD+ metabolism, stemness, the immune response, and cancer