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Research · Supplements

NAD+ infusions

A 2026 systematic review found no outcome trials of IV or injected NAD for anti-aging or wellness. In two small Chinese trials in heart patients, low-dose IV NAD raised ejection fraction by about 3 points over placebo. In a clinic record review, every person given 500 mg IV NAD reported moderate to severe symptoms during infusion. No trial measured lifespan.

Add to Bio HackChecked 2026-11-09
Status
Offered in US wellness clinics as an IV drip or injection. Not FDA-approved for any use.
Also called
NAD IV, NAD+ IV drip, NAD+ injection, nicotinamide adenine dinucleotide infusion, NAD therapy, NAD shots
Taken for
slowing aging, longer life, energy, fatigue, brain fog, focus, addiction recovery, withdrawal, recovery, well-being

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help2

Reported risks2

What people take it for, and what was found

Shown to help2

Limited

Heart function in heart disease

Small trials found slightly higher ejection fraction after low-dose IV NAD in heart attack and heart failure patients, with no difference in later cardiac events.

The numbers and sources
Effect
After a heart attack treated with PCI, 7 days of IV NAD gave a 30-day ejection fraction of 56.3% against 53.4% on placebo (p = 0.048). Adverse cardiac events at 6 months did not differ [1]. In heart failure from ischemic cardiomyopathy, ejection fraction at 1 month was 45.4% against 42.4% on placebo (p = 0.024). The 6-month event rate was 14.6% against 24.7%, not a significant difference [2]. In older adults with heart failure, NT-proBNP and ejection fraction improved more than on saline, but not significantly [3].
Population
120 patients with ST-elevation heart attack at 10 mg a day for 7 days [1]; 180 adults with ejection fraction of 45% or less at 10 mg a day for 7 days [2]; 60 older adults with heart failure at 50 mg a day for 7 days [3].
Sources
[1], [2], [3]
Caveats
Three single-center trials in China, two from the same group. The doses were 10 to 50 mg a day, far below the 500 to 750 mg infusions reported in wellness settings [4][5]. Trial [3] was registered retrospectively and lists a company, Knature, among its funders. These trials say nothing about healthy people.
Limited

Addiction recovery and withdrawal

One uncontrolled study of 50 people with substance use disorder found craving, anxiety and depression scores fell after infusions combining NAD with another agent.

Compared with before the infusions, in the same people [8]

The numbers and sources
Effect
In 50 people with poly-drug substance use disorder resistant to standard treatment, craving (P = 1.063E-9), anxiety (P = 5.487E-7) and depression (P = 1.763E-4) scores fell from baseline after infusions of NAD with an enkephalinase inhibitor. In a subset of 40, urine tests midway through the study detected no illicit drug use [8].
Population
50 adults with substance use disorder [8].
Sources
[8]
Caveats
No control group, so time and other care cannot be separated from the infusions. NAD was combined with an enkephalinase inhibitor, so its own share is unknown. Outcomes were Likert-scale ratings, and the abstract gives P values without effect sizes [8].

Not shown to help1

LimitedStudied in men

Blood NAD levels

One small study found plasma NAD did not rise during the first 2 hours of a 750 mg infusion, cleared as fast as it was given.

The numbers and sources
Effect
During a 6-hour infusion of 750 mg, plasma NAD and its metabolites did not change for the first 2 hours. NAD was cleared from plasma as fast as it was infused over that time. Urinary NAD and methylnicotinamide rose by 6 hours [5].
Population
11 healthy men aged 30 to 55, 8 given NAD and 3 given saline [5].
Sources
[5]
Caveats
A pharmacokinetic pilot with no clinical outcomes. A 2026 review treated it as context only [6].

Claimed, not studied in people2

Untested

Energy, fatigue and well-being

Not studied in people. In rodents, raising NAD often improved metabolic, mitochondrial and physical function measures, with results varying by model.

No study in people. This rests on animal studies.

The numbers and sources
Effect
A 2026 systematic review of 80 rodent studies found that raising NAD was frequently associated with improvements in metabolic, mitochondrial, inflammatory and functional outcomes, though effects varied across models and endpoints. It found no outcome trial of IV or intramuscular NAD for wellness in people [6].
Population
Rodents in 80 studies of NAD-related compounds given by mouth or by injection [6].
Sources
[6]
Caveats
Rodent results do not show how people feel after an infusion. The rodent studies covered NAD-related compounds in general, not infused NAD alone. No trial measured energy, fatigue or well-being after IV NAD [6].
Untested

Longer life

Not studied in people. No lifespan study of infused NAD was located, and mouse studies of oral NR, an NAD precursor, disagree.

No study in people. This rests on animal studies.

The numbers and sources
Effect
In one lab, NR raised NAD, rejuvenated muscle stem cells in aged mice and increased mouse lifespan [9]. In genetically mixed mice tested at three sites by the US National Institute on Aging program, NR did not increase lifespan in either sex [10].
Population
Aged mice [9]. Genetically heterogeneous mice at three sites [10].
Sources
[9], [10]
Caveats
Both studies gave NR by mouth, not NAD by infusion. Mouse lifespan results do not show what happens in people.

Risks

Reported risks2

Limited

Symptoms during infusion

Limited evidence: all 6 clinic clients given 500 mg IV NAD had cramping, nausea or chest pressure during infusion, while a slower research infusion had none.

The numbers and sources
Effect
All 6 clients given 500 mg IV NAD on 4 consecutive days reported moderate to severe abdominal cramping, diarrhea, nausea, vomiting, raised heart rate, throat pain, congestion and chest pressure during infusion. Symptoms stopped when the infusion ended. Infusions averaged 97 minutes for NAD and 37 minutes for IV NR. Five of 8 clients given IV NR reported minor tingling and cramping [4]. In the 6-hour research infusion of 750 mg, no adverse events were observed [5].
Population
14 clients of a commercial clinic, records reviewed retrospectively [4]; 11 healthy men [5].
Sources
[4], [5]
Caveats
The two studies disagree. They differ in infusion length, and both are very small. Study [4] was funded by the clinic chain that gave the infusions, all its authors were employed there, and the NR maker donated the NR.
Limited

Adverse effects reported across studies

Limited evidence: small uncontrolled studies and case reports described nausea, cramping, flushing and chest discomfort with IV NAD.

The numbers and sources
Effect
A 2026 review of human IV NAD data found the evidence consists mainly of small uncontrolled studies, observational reports and case reports. Reported adverse effects included nausea, cramping, flushing and chest discomfort [7].
Population
Human studies of IV NAD or IV NAD precursors published 2018 to March 2026 [7].
Sources
[7]
Caveats
A narrative review. It did not pool rates.

Checked, no increase found1

Limited

Liver and kidney markers

Limited evidence: two small studies found no change in liver, kidney or thyroid markers over 30 days after IV NAD infusions.

The numbers and sources
Effect
Over 30 days after four infusions, ALT, AST, hsCRP, BUN/creatinine and TSH did not change in either group. Alkaline phosphatase fell in the NAD group and stayed within normal range. HDL cholesterol fell in the NAD group [4]. In the research infusion, GGT, LD and AST fell at 8 hours [5].
Population
14 clinic clients [4]; 11 healthy men [5].
Sources
[4], [5]
Caveats
Tiny samples and short follow-up.

Possible, not studied in people1

UntestedHow often is not known

Long-term use

Not studied in people. Over 4 weeks, daily NAD injections in rats caused reversible injection-site and nerve lesions. Higher single doses raised heart rate in dogs.

No study in people. This rests on animal studies.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
In standardized toxicity studies, single intramuscular NAD injections in dogs at the higher doses tested raised heart rate, shortened PR and QT intervals and lowered blood pressure. Daily injections in rats for 4 weeks caused injection-site and sciatic nerve lesions that reversed after a 4-week recovery. Irritation, hemolysis and anaphylaxis tests were negative [11]. A 2026 review found long-term safety data in people lacking [7].
Population
Beagle dogs, rats, rabbits and guinea pigs [11]. Human studies of IV NAD [7].
Sources
[11], [7]
Caveats
Short animal studies of intramuscular injection. No study followed people through repeated infusions over months or years.

Claims tested and not found

  1. That IV NAD has been tested for anti-aging or wellness outcomes. A systematic review of studies from 2010 to October 2025 found no eligible outcome trials of IV or intramuscular NAD for these uses [6].

Sources

  1. Yu X, Cao J, Xu Q, et al. Effect of Intravenous Nicotinamide Adenine Dinucleotide on Left Ventricular Function After Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: A Randomized Controlled Trial. American Journal of Cardiovascular Drugs. 2026. https://doi.org/10.1007/s40256-026-00826-4
  2. Yu X, Xu J, Cao J, et al. Effect of Nicotinamide Adenine Dinucleotide on Heart Failure Caused by Ischemic Cardiomyopathy: A Randomized, Placebo-Controlled Trial. American Journal of Cardiovascular Drugs. 2025. https://doi.org/10.1007/s40256-025-00764-7
  3. Pei Z, Dong M, Meng X, et al. Effects of Nicotinamide Adenine Dinucleotide on Older Patients with Heart Failure. Reviews in Cardiovascular Medicine. 2024. https://doi.org/10.31083/j.rcm2508297
  4. Reyna K, Heinzen G, Patel N, et al. Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. Frontiers in Aging. 2026. https://doi.org/10.3389/fragi.2026.1652582
  5. 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+. Frontiers in Aging Neuroscience. 2019. https://doi.org/10.3389/fnagi.2019.00257
  6. Gallagher C, Emmanuel OO. NAD⁺ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Research Reviews. 2026. https://doi.org/10.1016/j.arr.2026.103057
  7. Alangari A, Arif J, Al Qureshah F, et al. Narrative review of intravenous NAD+ and NAD+ precursors in wellness and translational medicine. Frontiers in Aging. 2026. https://doi.org/10.3389/fragi.2026.1887175
  8. Blum K, Han D, Baron D, et al. Nicotinamide Adenine Dinucleotide (NAD+) and Enkephalinase Inhibition (IV1114589NAD) Infusions Significantly Attenuate Psychiatric Burden Sequalae in Substance Use Disorder (SUD) in Fifty Cases. Current Psychiatry Research and Reviews. 2022. https://doi.org/10.2174/2666082218666220527114427
  9. Zhang H, Ryu D, Wu Y, et al. NAD⁺ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science. 2016. https://doi.org/10.1126/science.aaf2693
  10. Harrison DE, Strong R, Reifsnyder P, et al. 17-a-estradiol late in life extends lifespan in aging UM-HET3 male mice; nicotinamide riboside and three other drugs do not affect lifespan in either sex. Aging Cell. 2021. https://doi.org/10.1111/acel.13328
  11. Gu J, Xu J, Yang S, et al. Non-clinical safety evaluation of coenzyme I (NAD⁺): A GLP-compliant systematic study. Biomedicine & Pharmacotherapy. 2026. https://doi.org/10.1016/j.biopha.2026.119934

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