Mitochondrial & antioxidant
NAD+
A coenzyme central to cellular energy, sold as an infusion for ageing and fatigue on modest, indirect human evidence.
What it is
Nicotinamide adenine dinucleotide is a coenzyme present in every cell, shuttling electrons in energy metabolism and acting as a substrate for enzymes involved in DNA repair and stress response. Levels fall with age. It is sold as intravenous or subcutaneous infusions and as oral precursors such as nicotinamide riboside and NMN. None of these is an approved treatment for ageing, fatigue or addiction.
How it works
- 1
Carries electrons in the reactions that turn food into ATP.
- 2
Supplies the substrate that sirtuins and PARP enzymes need; both are involved in DNA repair and cellular stress response.
- 3
NAD+ falls with age and in metabolic disease, which is the rationale for supplementing it.
- 4
Infused NAD+ reaches blood cells but is poorly taken up by other tissues; oral precursors raise whole-body NAD+ more reliably.
- 5
Raised NAD+ in humans has not been shown to produce clinical benefits in controlled trials.
What it's studied for
Reported and studied effects
- Measured NAD+ levels rise with precursors
- Small improvements in some metabolic markers in early trials
- No demonstrated effect on lifespan, frailty or cognition in people
- Temporary flushing and nausea with rapid infusion
Research protocol notes
Research context onlyResearch context only — no approved regimen exists. Clinics give infusions of roughly 250–1000 mg over one to several hours, often weekly; the slower the infusion, the milder the side effects. Vendors sell escalating weekly schedules such as 25 mg rising to 150 mg, with syringe units that are meaningless without the vial concentration. Oral precursor trials used 250–1000 mg daily. None of these are validated against a clinical outcome.
These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.
Possible side effects and contraindications
Safety profile
Possible side effects
- Flushing, warmth, chest tightness or breathlessness if infused quickly
- Nausea, headache, dizziness
- Fatigue after infusion
- Infection and vein inflammation from repeated intravenous access
- Oral precursors: mild nausea and itching at higher doses
Contraindications and cautions
- Active cancer — NAD+ supports cell proliferation and the question is unresolved
- Pregnancy and breastfeeding
- Kidney or liver disease
- Intravenous use outside a clinical setting
A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.
Evidence assessment
Oral precursors reliably raise NAD+ in humans and several small trials exist, but clinical outcomes remain unproven and infusion protocols have no regulatory approval.
References
- 01NAD+ precursors in humans (NR, NMN) — PubMed search
- 02NAD+ decline and sirtuin biology — PubMed search
References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.
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