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For instance, in one 1960s study of intravenous NAD+ for addiction, patients who received a fast IV drip experienced immediate headache and shortness of breath, whereas those given the same dose at a slower drip rate (under approximately 35 drops/min) had no distress

This may occur in patients even without evidence of adrenal insufficiency

Initial Treatment Dosages for Severe Deficiency Adults with severe vitamin B12 deficiency often start with higher doses

[1] [2] Injecting cold medication directly from the refrigerator may increase the likelihood of injection site reactions