NAD+

Ingredient · In our NAD+ Capsule, NAD+ Injection and NAD+ Nasal Spray

NAD+ (nicotinamide adenine dinucleotide)

A molecule every one of your cells runs on, and one of the most hyped words in wellness right now. Here's what it does, why it's in these products, and what the research can and can't tell you yet.

Photos are illustrations, not the medicine. Your body makes its own NAD+ from vitamin B3, but the NAD+ in these medicines is made in a lab.¹

The studies below used FDA-approved products or other forms. Our compounded version hasn't been studied in trials, and results may differ.

What it is

NAD+ is a coenzyme, a helper molecule that enzymes need to do their jobs. Your cells use it to turn food into energy, and more than 400 enzymes depend on it.¹ It also powers enzymes involved in repairing DNA, including the sirtuins you may have seen in longevity headlines.²

You make your own NAD+ from vitamin B3 (niacin) in foods like peanuts, brown rice and fish, and from tryptophan, an amino acid in protein.¹

Why it's in these products

In lab and animal studies, NAD+ levels fall with age in many tissues, and that drop is linked to age-related changes in metabolism.² In people, a study of skin samples found lower NAD+ in older adults, in women as well as men.³ Topping NAD+ back up is the idea behind these products.

The story is messier than the marketing, though. A 2026 review points out that large human datasets show blood NAD+ doesn't necessarily drop with healthy aging.⁴ So treat "your NAD+ is running out" as a hypothesis, not a diagnosis.

What the studies in people show

• Oral precursorNAD+ levels went up, and it was well toleratedIn a 6-week placebo-controlled trial in healthy middle-aged and older adults, nicotinamide riboside (a building block of NAD+) raised NAD+ levels. Possible effects on blood pressure and artery stiffness need bigger trials.⁵
• Oral precursor, womenBetter muscle insulin sensitivity after menopauseIn a 10-week placebo-controlled trial of postmenopausal women with prediabetes, the precursor NMN improved how muscle responded to insulin.⁶ One small study, and it used a precursor, not NAD+ itself.
• Oral precursorMore NAD+ in muscle, fewer inflammation markersIn older men, nicotinamide riboside raised NAD+-related molecules in muscle and lowered some inflammatory markers in the blood. It did not change how muscle mitochondria produced energy.⁷
• Review of trialsGenerally well tolerated, mild side effectsA 2024 systematic review of 10 randomized trials (489 people) found NAD+ and its precursors were generally well tolerated. Side effects included muscle pain, fatigue, trouble sleeping and headaches, none considered serious.⁸
• InjectionThe human evidence is thinA 2026 review of IV NAD+ found mostly small studies without placebo groups and called the evidence preliminary.⁴ In one pilot study, NAD+ infused into a vein was cleared so fast that blood levels didn't rise for the first two hours.⁹
• Nasal sprayNo human trials yetWe searched PubMed and found no published human trials of NAD+ nasal spray as of November 2026. The research so far is in cells and mice.¹⁰

What we don't know yet

Whether NAD+ products change how energetic, sharp or "young" you feel day to day. Which form, if any, works best: swallowed, injected or sprayed. And what happens with long-term use, because long-term safety data don't exist yet.⁴

Safety, in plain English

Side effects reported with IV NAD+ include nausea, cramping, flushing and chest discomfort.⁴ Oral NAD+ and its precursors have been linked to muscle pain, fatigue, sleep trouble and headaches.⁸

Our NAD+ products are compounded by a licensed pharmacy. Compounded medications are not FDA-approved, which means FDA hasn't checked their safety, effectiveness or quality before they're sold.¹¹ That's one reason a licensed clinician reviews your health history and decides whether NAD+ is appropriate for you. Exploring it here never means you'll get a prescription.

Sources

1. National Institutes of Health, Office of Dietary Supplements. Niacin: Fact Sheet for Health Professionals. NIH ODS
2. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22:119-141. PubMed 33353981
3. Massudi H, Grant R, Braidy N, et al. Age-associated changes in oxidative stress and NAD+ metabolism in human tissue. PLoS One. 2012;7:e42357. PubMed 22848760
4. Alangari A, et al. Narrative review of intravenous NAD+ and NAD+ precursors in wellness and translational medicine. Front Aging. 2026;7:1887175. PubMed 42787547
5. Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9:1286. PubMed 29599478
6. Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021;372:1224-1229. PubMed 33888596
7. Elhassan YS, Kluckova K, Fletcher RS, et al. Nicotinamide riboside augments the aged human skeletal muscle NAD+ metabolome and induces transcriptomic and anti-inflammatory signatures. Cell Rep. 2019;28:1717-1728. PubMed 31412242
8. Gindri IM, et al. Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review. Am J Physiol Endocrinol Metab. 2024;326:E417-E427. PubMed 37971292
9. Grant R, Berg J, Mestayer R, et al. A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD+. Front Aging Neurosci. 2019;11:257. PubMed 31572171
10. Yoo SH, et al. Therapeutic effect of intranasal nicotinamide adenine dinucleotide in the restoration of olfactory dysfunction (cell and mouse study). Exp Mol Med. 2026;58:2155-2167. PubMed 42380286
11. U.S. Food and Drug Administration. Compounding and the FDA: Questions and Answers. FDA

Sources checked November 8, 2026. This page is general education, not medical advice, and it doesn't mean any treatment is right for you. Photos: Unsplash (Martin Brechtl, Susan Wilkinson, Majid Shirvani).