NAD+

What it is

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell. It is not a peptide. It shuttles electrons in the reactions that turn food into ATP, and it is the fuel consumed by enzymes involved in DNA repair (PARPs) and by the sirtuins, a family of proteins linked to ageing in animal research.

Animal research suggests NAD+ levels fall with age. That observation is the whole basis of the NAD+ market: if levels drop, perhaps topping them up slows ageing. There are two ways people try to do that. One is to put NAD+ itself into the body by intravenous drip or injection. The other is to take a precursor by mouth, mainly nicotinamide mononucleotide (NMN) or nicotinamide riboside (NR), and let cells build their own NAD+.

How it works

NAD+ is a large, charged molecule that does not pass easily into cells. Much of what is infused is thought to be broken down outside cells into smaller pieces such as nicotinamide and NMN, which cells then take up and rebuild into NAD+. That is one reason researchers argue the precursor route may reach the same end point.

The precursors enter the NAD+ "salvage" pathway directly. NR is converted to NMN inside the cell, and NMN is converted to NAD+. Both have been shown in humans to raise NAD+ or its markers in blood.

What the research found

Injectable and IV NAD+

Human data on infused NAD+ is thin.

• Grant and colleagues (2019) gave eight healthy men 750 mg of NAD+ by IV over six hours, with three men receiving saline. Plasma NAD+ and its breakdown products did not change for the first two hours, meaning the infused NAD+ was removed from the blood almost as fast as it went in. Levels rose later in the infusion, and NAD+ and methylnicotinamide appeared in the urine. No adverse events were reported at this slow rate.
• Reyna and colleagues (2026) reviewed clinic records for 14 people given IV NAD+ or IV NR, 500 mg for four days. All six in the NAD+ group reported moderate to severe gut symptoms, a faster heart rate and chest pressure, and their drips took on average 97 minutes versus 37 for NR. This was retrospective and tiny.

No controlled trial has shown that IV or subcutaneous NAD+ improves energy, cognition, recovery or any ageing outcome. We found no published human study of subcutaneous NAD+ at all.

Oral precursors: NR and NMN

The precursor trials are better designed, and their results are more modest than the marketing.

• Martens and colleagues (2018) gave 24 healthy adults aged 55 to 79 NR or placebo for six weeks each in a crossover design. Blood cell NAD+ rose by about 60%. Blood pressure and arterial stiffness showed trends toward improvement that did not hold up as statistically significant overall.
• Elhassan and colleagues (2019) gave 12 older men 1 g of NR daily for 21 days. Muscle NAD+-related metabolites rose and some inflammatory markers fell, but mitochondrial function in muscle did not change.
• Yoshino and colleagues (2021) gave 25 postmenopausal women with prediabetes NMN or placebo for ten weeks. Insulin sensitivity in muscle improved. Blood glucose, blood pressure, lipids, liver insulin sensitivity, liver fat and inflammation markers did not. The lead investigator said it was premature to make clinical recommendations.

The pattern: precursors reliably raise NAD+ markers, while downstream health effects in humans have been small, isolated or absent.

Side effects reported in studies

With IV NAD+, the reported problems in the 2026 clinic review were nausea and gut discomfort, a faster heart rate and chest pressure during the drip, all of which resolved once the infusion ended. The slower six-hour infusion in the 2019 pilot produced no adverse events. Subcutaneous NAD+ is widely described as painful at the injection site, though we found no study quantifying this. Oral NR at 1 g per day was well tolerated in the trials above, with mild self-reported symptoms and no serious adverse events.

Injectable NAD+ vs oral precursors

For other mitochondrial compounds, see MOTS-c and SS-31.

Status in the Philippines

NAD+ is not a controlled substance. We could not confirm any NAD+ injection registered with FDA Philippines. IV NAD+ is offered by wellness and aesthetic clinics in Makati, BGC and other Metro Manila areas, and NAD+ vials are sold through research-chemical channels. Any injectable made outside a registered, sterile manufacturing process carries contamination risk, which matters more for an IV product than for anything else on this site. If you have a heart condition, it is a conversation for a licensed Philippine physician before any infusion.

Local stock NAD+ 1000mg at Primara Labs, delivered in Metro Manila and nationwide. Research use only.

Storage

NAD+ powder degrades with heat, light and moisture. Keep sealed vials refrigerated and dark. Once reconstituted, keep at 2 to 8°C and use promptly. During a brownout, keep the fridge closed. See the beginner guide for handling basics.