Most of the reported side effects for NAB precursors like NAM, NR, and NMN are relatively rare and minor,

for example, diarrhea, nausea, rashes, rashes, hot flashes, and leg cramps.

Both NR and NMN raise NAM level, so may shear in

the same concerns regarding searchwind inhibition, methyl depletion, and potential adverse

effects of NAM breakdown products. Another theoretical concern of NAD boosting is the exacerbation of infections by a group of bacteria called homophilus,

from the Greek meaning blood-loving, though can also cause infections of the lung, brain, throat, flesh, and joints.

Homophilous bacteria lack the ability to make NAD, so rely on host levels,

raising the possibility that higher blood levels

might worsen the disease course of infected individuals. Ironically, elevated NAD levels

may also fuel immune system overreaction in cases of autoimmune and inflammatory disease.

When fully activated, the immune system is voracious. The immune reaction

to a blood infection or extensive burns can burn 4,000 calories a day, approximating military

training in the Arctic. Since NAD is used by cells to produce energy, it's no surprise

that we find the primary NAD synthesizing enzyme strongly upregulated in tissues

that are actively inflamed.

For example, the enzyme NAMPT is elevated in colonoscopy biopsies taken from inflamed areas

in patients with inflammatory bowel disease, and higher levels are correlated with greater disease severity.

So, for those suffering from chronic autoimmune diseases such as rheumatoid arthritis,

NAD boosting could potentially have a profound negative impact.

This explains why tamping down NAD with NAMPT inhibitors has been shown to ameliorate

colitis and arthritis in mice, but this has yet to be tested in people.

Such NAD depleting drugs have, however, been used in cancer patients.

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