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They can suggest ways to treat or manage the side effects.Before taking this medicine, inform your doctor if you have any kidney, liver or heart problems

2018 Oct 01;112(10):423-435

Optimizing sleep and hormonal output helps maximize NAD-driven fat loss

That is a very different statement from they do nothing. It means: The mechanistic rationale is real

Doses greatly exceeding the nutritional requirements (for example, hundreds of milligrams daily) have not been studied in randomized trials for safety, so one should avoid mega doses in pregnancy unless treating a specific condition (such as pyridoxine-responsive seizures) under careful supervision