Library / Longevity

NAD+

Also known as Nicotinamide adenine dinucleotide, NAD

Largely unstudied

Not a peptide: a coenzyme involved in cellular energy metabolism. Oral precursors have been studied in human trials, but injected or infused NAD+ has very little published clinical research.

Not an approved medicine. NAD+ is not an approved medicine for this use in Australia or the United States. This page summarises published research for information only. It is not a recommendation to use NAD+, and VialOwl does not sell or supply it.

Background

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell, first identified in the early 1900s. It is made in the body from vitamin B3 forms and other precursors. Intravenous and injected NAD+ is now offered in wellness clinics, while oral precursors such as nicotinamide riboside are sold as supplements.

How it is thought to work

NAD+ carries electrons in the reactions that turn food into energy and is used up by enzymes involved in DNA repair and cell stress responses, such as sirtuins and PARPs. Injected NAD+ is quickly broken down in the blood, so how much reaches cells is unclear.

What is claimed, and the evidence

Claim	Evidence	Notes
Raises NAD+ levels in the body (oral precursors NR and NMN)	Human trials Mixed results	Randomised trials consistently show biochemical increases, but effects on function and health outcomes are mixed or null.
Anti ageing, energy and wellness from IV or injected NAD+	No published evidence	A 2026 systematic review found no outcome trials of IV or injected NAD+ for these uses.
Addiction withdrawal, sleep and neurological symptoms (IV)	Small human studies	Small uncontrolled studies and case reports only; clinical significance uncertain.
Restores NAD+ that falls with age	Small human studies	Large human data suggest whole blood NAD+ does not decline with healthy ageing, weakening the rationale.

Side effects

Effect	How often	Notes
Nausea	Common	Reported with IV infusion in small studies and reviews.
Abdominal cramping	Common	Reported with IV infusion, often linked to infusion speed.
Flushing	Common	Reported with IV infusion.
Chest discomfort or tightness	Uncommon	Reported with IV infusion in the 2026 narrative review.
Long term effects	Frequency unknown	No long term safety data for IV or injected NAD+.

Warnings

Evidence for IV or injected NAD+ is preliminary and a 2026 review concluded it is insufficient to support routine clinical or wellness use.
Infusion reactions such as chest discomfort, cramping and nausea are reported.
Unapproved products are not assessed by the TGA for quality, safety or efficacy and may be contaminated, non-sterile, underdosed, overdosed or contain a different substance altogether.

Regulatory status

Australia: At least one oral NAD+ product appears on the ARTG (listed complementary medicine search result). No injectable NAD+ product verified on the ARTG.
United States: Not FDA approved as a drug. In 503A Category 1 (under evaluation for compounding).

Sources

Also in Longevity

From the VialOwl library, reviewed 26 September 2026. For education and general information. It is not medical advice and not a recommendation to use NAD+.