In these people, pernicious anemia develops at about age 60
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Some describe feeling: Warmth in the face or chest A brief increase in energy or alertness Mild tingling A temporary metallic taste Mild pressure or cramping sensation These sensations are usually short-lived and are thought to reflect the rapid cellular and metabolic activity triggered by NAD as it supports mitochondrial function and cellular energy production
Hong S, Moreno-Navarrete JM, Wei X, Kikukawa Y, Tzameli I, Prasad D, Lee Y, Asara JM, Fernandez-Real JM, Maratos-Flier E, Pissios P. Nicotinamide N-methyltransferase regulates hepatic nutrient metabolism through Sirt1 protein stabilization. Nat Med. 2015 Aug;21(8):887-94. doi: 10.1038/nm.3882. Epub 2015 Jul 13. PMID: 26168293; PMCID: PMC4529375