NAD+

Key points

• NAD+ (nicotinamide adenine dinucleotide) is a natural molecule found in every cell, central to energy production and DNA repair.
• Levels are thought to fall with age, which is the basis for the interest in topping it up.
• Oral precursors such as NMN and NR are sold as food supplements. IV and injectable NAD+ are offered as wellness treatments at some clinics.
• It is not a licensed medicine in the UK, and the clinical evidence for the drips and injections is limited.

Quick facts

What it is

NAD+, a naturally occurring coenzyme

Studied for

Energy, metabolism and ageing

Forms

Oral precursors (NMN, NR); IV and injectable NAD+

UK status

Not a licensed medicine; supplement and wellness use

Human evidence

Limited; mostly small studies of oral precursors

How it works

Inside cells, NAD+ helps the mitochondria turn nutrients into usable energy. It is also needed by two families of enzymes: sirtuins, which help regulate metabolism and gene activity, and PARPs, which help repair damaged DNA. The idea behind supplements and drips is that raising NAD+ supports all of these at once. Whether topping it up from outside the body reaches the right places and makes a lasting difference is still being studied.

What the evidence shows

Most of the encouraging evidence is from animal and laboratory work, where NAD+ and its precursors affect energy use and markers of ageing. Human trials are smaller and mostly test oral precursors rather than drips. One example found that an oral precursor improved a measure of insulin sensitivity in older adults. Good human evidence for IV NAD+ specifically, and for the long term benefits people hope for, is still thin.

What it does not settle

• There is little controlled human evidence that IV NAD+ changes outcomes people care about.
• Oral precursors and IV drips have not been compared head to head.
• Long term safety of repeated high doses, and the best dose, are not established.

Side effects

Common

• During an infusion people commonly report flushing, nausea, headache or a feeling of chest tightness, which usually ease when the drip is slowed down.
• Injections under the skin can cause redness or tenderness at the site.
• Oral precursors can cause mild stomach upset at higher doses.

Less common but serious

• A fast infusion can cause a drop in blood pressure, more likely if you are dehydrated.
• Anyone with cancer, or taking medicines that suppress the immune system, should seek medical advice first, since the effects of raising NAD+ in these situations are not well understood.

Report any suspected side effect through the MHRA Yellow Card scheme.

UK legal status and access

NAD+ is not a licensed medicine in the UK. Oral precursors are sold as food supplements. IV drips and injections are offered as wellness treatments at some private clinics, which should be registered and overseen by a suitable health professional. A drip is a procedure with its own risks, so it is worth checking who is giving it and how.

Common questions