Cellular coenzyme fact sheet
NAD+
Also known as nicotinamide adenine dinucleotide, NAD
NAD+ helps cells transfer energy and support many enzymes. That important biology has not yet translated into proof that NAD+ infusions improve aging, cognition, energy, or recovery.
Quick answer
NAD+ is essential to human biology, but intravenous or intramuscular NAD+ is not FDA approved for anti-aging, energy, cognition, addiction recovery, or wellness. A recent systematic review found no eligible clinical outcomes trials of NAD+ itself for those goals.
By the PeptideFactSheets Editorial Team. Claims are source-checked under our editorial policy; clinician review is identified only when a named reviewer is shown.
What is NAD+?
NAD+ is a coenzyme found in every living cell. It participates in energy metabolism, redox reactions, DNA-repair signaling, and enzymes such as sirtuins.
NAD+ itself is distinct from precursors such as nicotinamide riboside and nicotinamide mononucleotide. Raising a blood biomarker with a precursor is also different from proving a meaningful health outcome.
Why are people interested in it?
NAD+ biology intersects with metabolism, mitochondrial function, DNA repair, inflammation, and aging research.
Commercial infusion programs often move from that mechanism to broad benefit claims faster than controlled human evidence allows.
Current regulatory status
NAD+ is not an FDA-approved drug for anti-aging, wellness, cognition, fatigue, or addiction treatment. Compounded drugs are not reviewed by FDA before marketing for safety, effectiveness, or quality.
What is it approved for?
No FDA-approved use. Commercial availability, supplement marketing, and clinical research do not equal an FDA-approved medicine.
What is it being studied for?
Evidence snapshot
Human studies can describe pharmacokinetics or short-term laboratory changes, but controlled evidence for patient-centered benefits from NAD+ itself is missing. Reviews of NAD-boosting interventions find more biomarker evidence than reproducible functional benefit.
Potential benefits being researched
- A small infusion study described changes in circulating NAD-related metabolites but did not establish a clinical benefit.
- NAD precursors often increase NAD-related biomarkers in human trials; benefits in physical, cognitive, or metabolic outcomes are inconsistent and cannot be assigned to NAD+ infusions.
A mechanism, biomarker, or secondary endpoint is not proof of a meaningful clinical benefit.
Known or possible risks
- FDA has received adverse-event reports involving compounded NAD+ products, including severe chills, shaking, vomiting, and fatigue, and has warned about unsuitable ingredients used in sterile compounding.
- A retrospective commercial-clinic study reported frequent gastrointestinal symptoms and changes in heart rate or chest pressure during NAD+ infusions; it did not establish efficacy.
- Compounded sterile products can introduce contamination, potency, and quality risks that are separate from the molecule's theoretical biology.
What we still do not know
- Whether NAD+ itself produces durable clinical benefits in any wellness population
- Which route, formulation, or population could justify controlled outcomes trials
- Long-term safety of repeated exposure
- Whether changes in NAD-related biomarkers translate into better function or health
Plain-English takeaway
NAD+ is biologically fundamental, but biological importance is not clinical proof. Wellness-infusion claims currently outrun controlled outcomes evidence and add compounding-related risks.
Research and reference links
Use these primary and authoritative sources to verify status and read beyond this summary. A study or registry entry does not by itself prove benefit.
- 1Systematic review of NAD-related anti-aging interventions
Review finding no eligible clinical outcomes trials of intravenous or intramuscular NAD+ itself for anti-aging or wellness.
- 2FDA: reminder about ingredients used in sterile compounding
FDA warning describing adverse-event reports and quality concerns involving compounded NAD+ products.
- 3Pilot pharmacokinetic study of an NAD+ infusion
Small study of plasma and urine metabolites that did not test meaningful clinical efficacy.
- 4Retrospective commercial-clinic NAD+ infusion study
Nonrandomized safety and tolerability report that cannot establish benefit.