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Jamie Winn, PharmD, is a licensed pharmacist and seasoned medical content reviewer with over 20 years of experience in clinical pharmacy, patient care, and healthcare leadership

These include: Large amounts of alcohol Foods that are high in phytic acid, such as whole grains and legumes Foods that are high in calcium, such as antacids and calcium supplements Pernicious Anemia Treatments Pernicious anemia is a serious condition that requires treatment to prevent serious health problems

Even if NAD+ survives gastric digestion, its large molecular size (approximately 663 daltons) and negative charge make it poorly suited for passive diffusion across intestinal epithelial cells

Multi-dose vials typically remain stable for 28 to 30 days after first puncture when refrigerated at 36F to 46F (2C to 8C)