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Psychological adverse reactions-including severe irritability or psychotic symptoms-are possible, particularly with excessive use or in vulnerable individuals

Risks may be heightened for individuals with underlying health conditions

The only reliable way to determine whether you have a vitamin B12 deficiency is through blood testing ordered by a qualified healthcare provider

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Alternatively, extracellular NAD + can be utilized by NAD + glycohydrolases, generating NAM, NR, or NMN outside of the cells, which can then be transported intracellularly for NAD + synthesis 65,66