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Several users even viewed nausea and facial flushing as signs that the product was working rather than as warning signals to stop using it

Association of thyroid stimulating hormone and coronary lipid risk factors with lipid peroxidation in hypothyroidism
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The pressure of ADT leads to AR-activating alterations in androgen levels, the AR gene, and the elaborate and diverse molecular machinery that AR needs to engage to alter transcription of its target genes

doi: 10.3390/antiox11020416

Conclusion: direct IV NAD+ has a real biological effect , although the mechanism is more complex than simple replenishment of the NAD+ pool (via metabolites)
