Skip to content
Educational information only. Not medical advice. We sell nothing and take no affiliate money.
By /
Coenzyme (not a peptide)Limited humanNot FDA approved

NAD+

Nicotinamide adenine dinucleotide

Last reviewed October 27, 2026 · 20 sources · Written for general readers · Compare with another compound →

The bottom line

NAD+ is a natural molecule your cells need to make energy. No controlled trial shows that NAD+ drips or shots improve energy, aging, focus or addiction recovery, and drips often cause stomach upset and chest pressure while they run. Pills the body turns into NAD+ (NR and NMN) do raise NAD+ in people, but in trials they mostly failed to improve blood sugar, blood pressure, brain fog or fitness.

Where the evidence stands

What it is

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme, a helper molecule that enzymes need to work. It is central to how cells turn food into energy. It is not a peptide.[1][2]

It is sold in two very different forms. Clinics sell NAD+ itself as IV drips or shots. Supplement makers sell precursors, building blocks the body turns into NAD+, mainly nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), taken as pills or powders.[2]

Almost all human research is on the pills. Results from NR and NMN pills do not automatically apply to drips or shots, so this page says which form each finding comes from.[2][3]

Name
NAD+ (Nicotinamide adenine dinucleotide)
Other names
NAD, nadide, NAD IV drip, NAD injections
Type
Coenzyme (not a peptide)
CAS number
53-84-9
Formula
C21H27N7O14P2
Molecular weight
About 663.4 g/mol

How it works

The idea is that NAD+ levels fall with age, and topping them up will restore cell energy and repair.

  • In rodents, raising NAD+ often improved metabolism, mitochondria (the cell’s power plants) and inflammation, though results varied.[2]
  • Pills: oral NR reliably raises NAD+ in human blood. In one trial it raised NAD+ in blood cells by about 60 percent compared with placebo.[4]
  • Pills: NR also raised NAD+ related compounds inside the muscle of older men, and in people with Parkinson’s disease it raised NAD+ measured in the brain.[5][6]
  • Drips: when NAD+ was dripped into healthy men, blood levels did not rise for the first two hours. The body seemed to clear it fast and break it into other compounds.[3]

Raising a blood marker is not the same as improving health, and how much NAD+ from a drip or shot reaches cells is unknown.

What the research shows

We keep animal and human evidence apart. A result in animals is a reason to study something in people, not proof that it works in people.

Animal and lab studies

Promising but mixed in rodents

  • A 2026 review counted 80 rodent studies. Boosting NAD+ often helped metabolic, mitochondrial and inflammatory measures, but results varied.[2]
  • A 2020 review gathered lab and animal research suggesting that NAD+ and the enzymes that depend on it influence brain signals tied to craving and withdrawal.[10]
  • Rodent gains in blood sugar control have largely not carried over to human trials of the same precursors.[2][13]

Limit: Mouse results on aging and metabolism often fail to carry over to people.

Human studies

Pills: many small trials, mostly null. Drips and shots: almost no data

  • IV or injected NAD+: a 2026 systematic review found no eligible outcome trials testing NAD+ itself for aging or wellness.[2]
  • IV NAD+ pilot: eight healthy men got a six hour NAD+ drip and three got saline. Only blood and urine levels were tracked. NAD+ did not rise in blood for the first two hours. No side effects were seen during the drip, and small liver enzyme changes afterward were judged not meaningful. One author directed a clinic selling NAD+ drips, and a company in that field cofunded the study.[3]
  • IV NAD+ clinic records: a 2026 review compared IV NAD+ with IV NR given four days in a row. NAD+ drips took about 97 minutes versus 37 for NR and caused moderate to severe stomach symptoms, faster heart rate and chest pressure during the drip. Symptoms went away afterward. Most authors worked for the clinic chain.[16]
  • Injected NAD+: a registered trial comparing how painful NAD+ and NR shots are under the skin, into muscle and into a vein has posted no results.[17]
  • Oral NR, healthy older adults: in a six week crossover trial with 24 finishers aged 55 to 79, NR raised NAD+ in blood cells about 60 percent. Blood pressure, fitness, blood sugar and body fat did not change reliably.[4]
  • Oral NR, obese men: in 40 men over 12 weeks, NR did not improve insulin sensitivity, body composition or energy use. No serious side effects occurred.[13]
  • Oral NR, mild memory problems: in 20 older adults over 10 weeks, blood NAD+ rose 2.6 times, but thinking scores did not change. Side effects were similar to placebo.[8]
  • Oral NR, long COVID: in 58 adults taking NR for up to 20 weeks, NAD+ rose sharply, but over a 10 week placebo controlled phase, memory, fatigue, sleep, anxiety and depression did not improve versus placebo. Many people dropped out.[7]
  • Oral NR, Parkinson’s disease: in an early safety trial of 30 newly diagnosed patients over 30 days, NR was well tolerated and raised brain NAD+. Those with the biggest rise showed mild clinical improvement, which needs larger trials.[6]
  • Oral NMN: in 48 runners, six weeks of NMN with training improved some aerobic measures.[11] In women with prediabetes, 10 weeks of NMN improved muscle response to insulin.[14]

Limit: No controlled trial shows NAD+ drips or shots improve any health outcome, and pill trials have been small and short.

Claims check

The most common claims about this compound, and what studies actually found. Verdicts rate the evidence, not whether you should use it.

Boosts energy and fights fatigue

No benefit in trials so far

Pills: in a placebo controlled trial of 58 adults with long COVID, NR raised blood NAD+ about 2.6 to 3.1 times but did not ease fatigue, improve sleep or lift mood during its 10 week placebo controlled phase.[7] In healthy adults aged 55 to 79, six weeks of NR did not change fitness or treadmill time.[4] Drips and shots: no controlled trial has measured energy or fatigue.[2]

Clears brain fog and sharpens focus

No benefit in trials so far

Pills: in the long COVID trial, NR did not improve memory or thinking tests compared with placebo.[7] In a 10 week trial of 20 older adults with mild memory problems, NR raised blood NAD+ 2.6 times, but thinking scores did not change.[8] Drips and shots: no trial has tested them for brain fog.[2]

Slows aging and extends life

Only in animals

Longer life and healthier aging from raising NAD+ have been shown only in rodents.[2] A 2026 systematic review found 33 human studies of NR and NMN pills. They raised NAD+, but effects on body function were inconsistent and often absent, and no outcome trials of IV or injected NAD+ were found.[2]

Helps addiction recovery and eases withdrawal

Mixed results

This claim rests on uncontrolled clinic reports, not trials. A 2024 report described 50 people with substance use problems who got IV NAD+ mixed with other ingredients and rated their cravings, anxiety and low mood as better afterward, but there was no comparison group, so the effect of NAD+ alone is unknown.[9] A 2020 review said clinical studies are limited and the idea still needs proper testing.[10] We found no placebo controlled trial.

Builds muscle and improves workouts

Mixed results

Pills: in 48 recreational runners, six weeks of NMN during training improved some aerobic fitness measures but not peak oxygen uptake.[11] In 13 overweight adults, six weeks of NR raised the share of lean body mass by about 1.3 percentage points but did not improve muscle mitochondria.[12] In 12 older men, three weeks of NR did not change muscle energy production.[5] Drips: untested.[2]

Lowers blood pressure

Mixed results

Pills: in a six week crossover trial with 24 healthy adults aged 55 to 79, NR lowered top number blood pressure by about 4 points on average, but this was not statistically reliable after correction. A larger drop of about 9 points in people with higher starting pressure came from an after the fact analysis.[4] In 13 overweight adults, NR did not change 24 hour blood pressure.[12] Drips: no controlled data.

Improves blood sugar and insulin

Mixed results

Pills: in 40 obese men, 12 weeks of NR did not improve insulin sensitivity.[13] In a 10 week trial, NMN improved how well muscle responded to insulin in women with prediabetes.[14] A 2024 pooled analysis of eight NMN trials with 342 adults found no clear benefit on blood sugar, insulin, HbA1c or blood fats.[15] Drips: a clinic records review found no change in fasting blood sugar over 30 days.[16]

Known risks and side effects

  • Drip side effects. In clinic records, IV NAD+ caused moderate to severe stomach symptoms, faster heart rate and chest pressure during the drip, and drips ran nearly three times longer than NR drips.[16]
  • Little safety data for drips and shots. Human data on infused or injected NAD+ come from very small or uncontrolled studies, so long term safety is unknown.[2][3]
  • Pill side effects usually mild. In a six week NR trial, 7 of 30 people reported 14 mild side effects such as headache, nausea and flushing, and more happened on placebo than on NR.[4] An eight week trial found no difference in side effects between NR and placebo.[18]
  • Unregulated products. NAD+ is not an FDA approved drug and is still under FDA evaluation for compounding. Vials sold online for self injection have no oversight of purity, sterility or strength.[19]
  • Sport rules on IV drips. For athletes, WADA bans IV infusions of more than 100 mL in 12 hours outside hospital care, no matter what is in the bag.[20]

Regulatory status

Today: NAD+ is not FDA approved for any use. FDA lists NAD and NADH in Category 1, meaning they are still under evaluation for compounding.[19] NR is sold as a dietary supplement, not a drug.[18]

  1. First published study tracking NAD+ in human blood during an IV drip.[3]
  2. A systematic review finds no outcome trials of IV or injected NAD+ for aging or wellness.[2]
  3. FDA’s updated list keeps NAD and NADH under evaluation for compounding.[19]

Sources

  1. U.S. FDA Global Substance Registration System. Nadide (UNII 0U46U6E8UK). FDA GSRS
  2. Gallagher C, Emmanuel OO. NAD+ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Res Rev. 2026;116:103057. PMID 41655607
  3. Grant R, Berg J, Mestayer R, et al. A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+. Front Aging Neurosci. 2019;11:257. PMID 31572171
  4. Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9(1):1286. PMID 29599478
  5. Elhassan YS, Kluckova K, Fletcher RS, et al. Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD+ Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Rep. 2019;28(7):1717-1728.e6. PMID 31412242
  6. Brakedal B, Dolle C, Riemer F, et al. The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease. Cell Metab. 2022;34(3):396-407.e6. PMID 35235774
  7. Wu CY, Reynolds WC, Abril I, et al. Effects of nicotinamide riboside on NAD+ levels, cognition, and symptom recovery in long-COVID: a randomized controlled trial. EClinicalMedicine. 2025;89:103633. PMID 41357333
  8. Orr ME, Kotkowski E, Ramirez P, et al. A randomized placebo-controlled trial of nicotinamide riboside in older adults with mild cognitive impairment. GeroScience. 2024;46(1):665-682. PMID 37994989
  9. Blum K, McLaughlin T, Lewandrowski KU, et al. Complex NADASE Infusions Improve Clinical Outcome in Substance Use Disorder: Descriptive Annotation in Fifty Cases. J Addict Psychiatry. 2024;8(1):95-157. PMID 39949994
  10. Braidy N, Villalva MD, van Eeden S. Sobriety and Satiety: Is NAD+ the Answer? Antioxidants (Basel). 2020;9(5):425. PMID 32423100
  11. Liao B, Zhao Y, Wang D, et al. Nicotinamide mononucleotide supplementation enhances aerobic capacity in amateur runners: a randomized, double-blind study. J Int Soc Sports Nutr. 2021;18(1):54. PMID 34238308
  12. Remie CME, Roumans KHM, Moonen MPB, et al. Nicotinamide riboside supplementation alters body composition and skeletal muscle acetylcarnitine concentrations in healthy obese humans. Am J Clin Nutr. 2020;112(2):413-426. PMID 32320006
  13. Dollerup OL, Christensen B, Svart M, et al. A randomized placebo-controlled clinical trial of nicotinamide riboside in obese men: safety, insulin-sensitivity, and lipid-mobilizing effects. Am J Clin Nutr. 2018;108(2):343-353. PMID 29992272
  14. Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021;372(6547):1224-1229. PMID 33888596
  15. Chen F, Zhou D, Kong APS, et al. Effects of Nicotinamide Mononucleotide on Glucose and Lipid Metabolism in Adults: A Systematic Review and Meta-analysis of Randomised Controlled Trials. Curr Diab Rep. 2024;25(1):4. PMID 39531138
  16. Reyna K, Heinzen G, Patel N, et al. Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. Front Aging. 2026;7:1652582. PMID 41704678
  17. ClinicalTrials.gov. Absorption and Tolerability of Injectable Administration of Niagen+, Nicotinamide Riboside Chloride, as Compared to NAD+: a Double Blinded, Randomized, Controlled Clinical Trial. NCT06919328. NCT06919328
  18. Conze D, Brenner C, Kruger CL. Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults. Sci Rep. 2019;9(1):9772. PMID 31278280
  19. U.S. Food and Drug Administration. Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act. Updated May 14, 2026. FDA
  20. World Anti-Doping Agency. The Prohibited List (2026 List, in force from January 1, 2026). WADA
Medical disclaimer

This page is educational information only. It is not medical advice and does not replace care from a licensed medical provider. Do not use this page to decide whether to take any substance. Talk to a licensed medical provider first.

Found an error or a newer study? We correct pages fast.

Report a correction →
Scroll to Top