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Thus, direct NAD + administration may exhibit unique effects compared to NAD + precursors and modulators, warranting further investigation, especially given the rise of wellness and anti-aging clinics offering intravenous NAD + therapy, while clinical evidence is still scarce 119

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There is no published long-term human safety data, no completed RCT, and the most-cited theoretical concern remains angiogenesis in the context of undiagnosed cancer

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