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Description
They exist in a regulatory gray area, often sold with labels that say "for research purposes only." This matters for a few reasons: Quality control is inconsistent

(PubMed) Thompson CA, Cerhan JR

Instead, BTX-A administration is performed trans-orally at the level of the orbicularis oris muscle of the mouth in these patients

If you are pregnant or planning to become pregnant, you should not start NAD+ injections