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Other serious side effects can include dizziness or lightheadedness, swelling in the feet or ankles, severe shortness of breath or wheezing, chest pain or a fast heart rate, and bright red blood in the stools

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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