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These initial studies reported increased NAD + and NAM levels in plasma, and in urine, the excreted NAD + levels increased after 6 h 66 , but it must be noted that these trials utilized small cohorts and short testing periods, and only a minor trend for cognitive improvement was observed 117

As a consequence of this article, we included in our clinical reports a recommendation to check B12 levels prior to the next injection to clarify status

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