Summary
NAD+ is a coenzyme present in every living cell, essential for energy metabolism and for enzymes such as sirtuins and PARPs. Tissue levels fall with age in animals. Boosting NAD+ improves several ageing measures in mice, but human trials of precursors have shown modest or inconsistent effects on clinical outcomes.
How it works
NAD+ shuttles electrons in glycolysis and oxidative phosphorylation and is consumed by sirtuins (which regulate metabolism and stress responses), PARPs (DNA repair) and CD38. Intravenous NAD+ is rapidly broken down in plasma.
Research use cases
Areas where NAD+ has been studied. Inclusion here does not mean it works for that purpose.
- Age-related metabolic decline
- Mitochondrial disease
- Neurodegeneration models
- Addiction treatment (clinical use with limited evidence)
What the research found
In vivo evidence review
A review of NAD-boosting molecules summarized improvements in mitochondrial function, insulin sensitivity and healthspan in rodents, and called for well-designed human trials.1
IV infusion pharmacology
In a pilot study of 6-hour intravenous NAD+ infusion in healthy men, plasma NAD+ did not rise for the first two hours, then increased, while urinary metabolites indicated rapid breakdown. Nausea and discomfort were common at faster infusion rates.2
Safety and open questions
Infusion can cause flushing, nausea, chest tightness and cramping, especially at fast rates. Long-term effects of high-dose supplementation are not well characterized.
Regulatory status
Not an approved drug for these uses. Available as a supplement precursor (NR, NMN) and through clinics as an infusion outside of FDA approval.
Status was accurate when this page was last reviewed on October 26, 2026. Regulations change; check with the relevant authority before relying on it.
NAD+: common questions
Is NAD+ a peptide?
No. It is a dinucleotide coenzyme. We include it because it is often discussed alongside mitochondrial peptides and is supplied in vials for reconstitution.
Is NAD+ approved for human use?
Not an approved drug for these uses. Available as a supplement precursor (NR, NMN) and through clinics as an infusion outside of FDA approval.
References
- Rajman L, Chwalek K, Sinclair DA. (2018). Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence. Cell Metabolism.
- Grant R, Berg J, Mestayer R, et al. (2019). A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD. Frontiers in Aging Neuroscience.
Links open a PubMed search for the exact title, or the original source where one is given.