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Its proposed mechanisms include: 1

Vision changes: Some users notice temporary blurriness when blood sugar levels fluctuate rapidly

That it also inhibited the glucagon secretion that we talked about

Accompanying symptoms include: Intense joint pain that may be described as excruciating Visible swelling and redness around the affected joint Warmth to touch over the inflamed area Extreme tenderness even light touch or bedsheets may be unbearable Restricted movement of the affected joint Occasionally, low-grade fever and general malaise Symptoms may resolve spontaneously over 7-14 days even without treatment, but medical assessment is important to confirm the diagnosis, provide symptomatic relief, and prevent future attacks

And then they had a patient at the clinic that had a really unusual side effect

Impacts of Decrease in NAD + Levels with Aging and Obesity on Metabolic Organ Function The pathophysiological importance of NAD + biology in metabolic organs has been investigated using genetically engineered mice models