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The important thing is that NAD+ must be given by injection or infusion to be effective

But, even insulin needles vary by size and gauge

Clinical Nutrition, 38(4), 1747-1755

The large amount doesn't pose a danger because people with pernicious anemia absorb only a small fraction of it

We look forward to seeing you again and are happy to answer any questions you may have about the steps we take to keep you, and every patient, safe in our practice

[7] It is advisable for patients to inform their healthcare provider of all medications and supplements they are taking, so that potential interactions can be monitored and managed appropriately