NAD+ Therapy: What It Is, How It’s Given and What the Research Actually Shows

The biology behind NAD+ is some of the most interesting science in the aging field. The marketing around it often gets ahead of that science. Somewhere between the two is what patients need to know before they spend time and money on infusions or supplements.

I’ll explain what NAD+ is, why researchers are excited about it, what human studies have and haven’t found, and how I think about safety — including who should skip it.

What NAD+ does in the body

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell. It has two broad jobs:

• Energy metabolism. NAD+ shuttles electrons in the reactions that turn food into usable cellular energy.
• Cell maintenance. It is consumed by enzymes involved in DNA repair and in regulating cellular stress responses, including the sirtuins and PARPs that often appear in longevity headlines.

Your body makes NAD+ from dietary building blocks, including forms of vitamin B3 (niacin and nicotinamide) and the amino acid tryptophan.

Why researchers are interested

In animal studies, NAD+ levels decline with age in several tissues, and restoring them with precursors has improved markers of metabolism, muscle function and healthspan in mice. Human data suggest levels may fall with age as well, though measurement varies by tissue and method. This raised a natural question: could raising NAD+ slow aspects of human aging?

What human studies show so far

Human research has mostly tested oral precursors, such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), rather than IV NAD+ itself:

• They raise blood NAD+ levels. Controlled trials show oral NR and NMN reliably increase NAD+ and related metabolites in blood.
• They appear well tolerated in short-term studies.
• Clinical benefits are modest or inconsistent. One study in postmenopausal women with prediabetes found improved muscle insulin sensitivity with NMN, but many trials have not shown clear improvements in strength, endurance, blood pressure or metabolic health.
• Long-term outcomes are unknown. No trials show that raising NAD+ extends human lifespan or prevents age-related disease.

For IV NAD+ infusions specifically, published controlled data are sparse. Much of what circulates about energy, focus or addiction recovery comes from anecdote and small uncontrolled reports. As an addiction medicine physician, I want to be clear: NAD+ is not an established treatment for substance use disorders, and evidence-based therapies should not be delayed in its favor.

How it’s given, and what it feels like

NAD+ is offered as an IV infusion, an injection, or oral precursor supplements. IV NAD+ is typically infused slowly, often over a couple of hours, because faster infusion commonly causes:

• Chest tightness or pressure.
• Nausea and abdominal cramping.
• Flushing, headache and anxiety.

These usually ease when the infusion is slowed. Any IV also carries small risks of bruising, vein irritation and infection, which is why placement and monitoring should be done by trained medical staff.

Who should avoid NAD+ therapy or be cautious

• Pregnancy and breastfeeding: safety data are lacking.
• Active cancer: because NAD+ supports cellular energy and repair, there is a theoretical concern about fueling tumor cells. Discuss with your oncologist.
• Heart disease: chest symptoms during infusion can be confusing and concerning.
• Kidney or liver disease: metabolism of precursors and IV volume need individual review.

My take

If you want to support healthy aging, the interventions with the best evidence are unglamorous: regular exercise, strength training, sleep, not smoking, and managing blood pressure, blood sugar and weight. Those also happen to support your body’s own NAD+ metabolism. NAD+ therapy is a reasonable topic to explore with a physician if you understand that it remains investigational for most goals. Our longevity approach starts with comprehensive lab work so we can focus on what’s most likely to help you. We can also discuss IV therapy options and whether any fit your goals.

Frequently asked questions

Does NAD+ therapy slow aging?

There is no human evidence yet that it slows aging or extends lifespan. Research is ongoing.

Are oral NAD+ supplements as good as IV?

Oral precursors like NR and NMN have been shown to raise blood NAD+ levels. IV NAD+ has fewer controlled studies, so direct comparisons are limited.

Why does an NAD+ infusion feel uncomfortable?

Rapid infusion commonly causes chest tightness, nausea and flushing. Slowing the rate usually helps.

Is NAD+ safe?

Short-term studies suggest oral precursors are well tolerated. Long-term safety isn't established, and some people should avoid it.

Explore longevity care with us

If you’re curious about NAD+ or other longevity strategies, schedule a complimentary, no-commitment consultation. Care is provided by trained medical professionals under my oversight.

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References: Rajman L, Chwalek K, Sinclair DA. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metabolism. 2018. · Martens CR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications. 2018. · Yoshino M, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021.

This article is for general information only and is not medical advice. Treatments are provided only after consultation and evaluation by a licensed provider. Individual results vary.