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Endocrinology 146 , 458462 (2005)

Because insulin is released only when glucose levels are high, the risk of blood sugar crashing in patients who are not using insulin or other glucose-lowering drugs is rare

NAD+ n = 8 and Control n = 3) aged 30-55 years had their safety of IV infusion of NAD+ evaluated using liver function tests (serum, total bilirubin, alkaline phosphatase, alanine aminotransferase, gamma glutamyl transferase, lactate dehydrogenase, and aspartate aminotransfer

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This is the most serious warning issued by the FDA