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Infections and acute illnesses , including viral gastroenteritis, food poisoning, or antibiotic-associated diarrhoea, may coincidentally occur when someone has recently started B12 supplementation

The numbers tell an interesting story - nicotinamide (an NAD+ precursor) production increased from 56.5 metric tons in 2012 to 71.2 metric tons in 2016

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They demonstrated that a three-week supplementation of 1000 mg NR per day increased muscle NAD + metabolome, specifically NAAD and products of NAM clearance pathways, yet NAD + levels were not altered