NAD+
Nicotinamide adenine dinucleotide. We read all 60 studies. The protocol is below.
Free — puts NAD+ on your decision board.
Everything you need to start: dose, sourcing, safety, our verdict.
One purchase · yours forever
Built from 60 cited studies.
- you've been quoted $300 for an IV drip and want to know if it does anything — **the trial-grade oral dose is NR 250–1000 mg/day for 8–12 weeks** (Martens 2018 PMID 29602900); the loading-drip frame is marketing
- you read Sinclair, watch Bryan Johnson, and want the honest read on **NMN vs NR — NR is still legally a supplement in the US; NMN was reclassified by FDA as a drug in 2022** and the comparative-absorption data doesn't show NMN winning
- you're hungover and considering "the drip"
- you want a peptide — this isn't one (it's a cofactor)
- you expect the IV to do more than the oral precursors per dollar — the math says otherwise
- you have active malignancy — NAD+ pathways feed cancer-cell metabolism in ways nobody is sure about
- Any unusual symptoms — especially the cancer-mechanism flag for angiogenic peptides.
- 12 weeks of continuous use with no objective biomarker support to keep going.
- Tolerance signal (the protocol needs escalating doses to feel the same).
What it is.
NAD+ is nicotinamide adenine dinucleotide — not a at all, but a coenzyme found in every cell you have. It moves electrons inside the mitochondria during energy production and powers the sirtuins and PARPs, two enzyme families that handle DNA repair and metabolic signaling.
NAD+ levels drop with age in most tissues that have been measured. That observation is the entire engine behind the longevity-supplement industry — IV NAD+ drips, NMN and NR precursor capsules, NAD+ injections, sublingual lozenges.
The IV form is the cultural flagship. Clinics charge $300–$1,500 per drip, often marketed as anti-aging, hangover recovery, or cognitive support. Oral precursors (NMN, NR) are sold as supplements under DSHEA. None of it is for an anti-aging indication, because no such indication exists at the FDA.
TL;DR. 30-second version.
The compressed verdict — what NAD+ actually is, what the human evidence shows, and the watch-for in three bullets. Locked.
Get the report · $19 ↓Mechanism.
How the molecule actually works — receptor profile, downstream signaling, what to expect mechanistically.
Get the report · $19 ↓Evidence. What we actually know in humans.
The trial breakdown — phase, n, primary endpoint, who funded, what hit, what didn't.
Get the report · $19 ↓Dose. The actual protocol.
The specific protocol — dose, titration schedule, cycle pattern, frequency, route.
Sourcing. Where the cohort actually buys.
Sourcing breakdown — vendor methodology, red flags, our published test results, COA checklist.
Safety. Side effects.
The watch-for list — contraindications, drug interactions, monitoring labs, when to stop.
Get the report · $19 ↓Editorial position.
Our editorial position — explicit yes / no / depends, with the reasoning behind it.
Get the report · $19 ↓Citations.
- 01Xue X, et al. Nicotinamide adenine dinucleotide metabolism: driving or counterbalancing inflammatory bowel disease?. FEBS letters. 2023;597(9):1179-1192. PMID: 36310388.
- 02Yu F, et al. Nicotinamide Adenine Dinucleotide Supplementation to Alleviate Heart Failure: A Mitochondrial Dysfunction Perspective. Nutrients. 2025;17(11). PMID: 40507126.
- 03Bi YW, et al. Nicotinamide adenine dinucleotide phosphate oxidase in pancreatic diseases: Mechanisms and future perspectives. World journal of gastroenterology. 2024;30(5):429-439. PMID: 38414585.
- 04Navas LE, et al. Nicotinamide Adenine Dinucleotide (NAD) Metabolism as a Relevant Target in Cancer. Cells. 2022;11(17). PMID: 36078035.
- 05Shen J, et al. Nicotinamide adenine dinucleotide phosphate oxidase activation and neuronal death after ischemic stroke. Neural regeneration research. 2019;14(6):948-953. PMID: 30761998.
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- 06Lin Y, et al. Nicotinamide Adenine Dinucleotide-Loaded Lubricated Hydrogel Microspheres with a Three-Pronged Approach Alleviate Age-Related Osteoarthritis. ACS nano. 2025;19(18):17606-17626. PMID: 40315404.
- 07Hosseini L, et al. Nicotinamide adenine dinucleotide emerges as a therapeutic target in aging and ischemic conditions. Biogerontology. 2019;20(4):381-395. PMID: 30838484.
- 08Griffiths HBS, et al. Nicotinamide adenine dinucleotide (NAD+): essential redox metabolite, co-substrate and an anti-cancer and anti-ageing therapeutic target. Biochemical Society transactions. 2020;48(3):733-744. PMID: 32573651.
- 09Kang S, et al. Novel Approach to Skin Anti-Aging: Boosting Pharmacological Effects of Exogenous Nicotinamide Adenine Dinucleotide (NAD(+)) by Synergistic Inhibition of CD38 Expression. Cells. 2024;13(21). PMID: 39513906.
- 10Mortezaee K. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) and liver fibrosis: A review. Cell biochemistry and function. 2018;36(6):292-302. PMID: 30028028.
- 11Pollard CL. Can Nicotinamide Adenine Dinucleotide (NAD(+)) and Sirtuins Be Harnessed to Improve Mare Fertility?. Animals : an open access journal from MDPI. 2024;14(2). PMID: 38254361.
- 12Zhou ZD, et al. Oxidized nicotinamide adenine dinucleotide-dependent mitochondrial deacetylase sirtuin-3 as a potential therapeutic target of Parkinson's disease. Ageing research reviews. 2020;62:101107. PMID: 32535274.
- 13Fan L, et al. Impaired nicotinamide adenine dinucleotide (NAD(+) ) metabolism in diabetes and diabetic tissues: Implications for nicotinamide-related compound treatment. Journal of diabetes investigation. 2020;11(6):1403-1419. PMID: 32428995.
- 14Fujita H, et al. Novel insight into nicotinamide adenine dinucleotide and related metabolites in cancer patients undergoing surgery. Scientific reports. 2024;14(1):16557. PMID: 39019993.
- 15Gansemer ER, et al. Pathways Linking Nicotinamide Adenine Dinucleotide Phosphate Production to Endoplasmic Reticulum Protein Oxidation and Stress. Frontiers in molecular biosciences. 2022;9:858142. PMID: 35601828.
- 16Sugishita Y, et al. Nicotinamide Adenine Dinucleotide (NAD)-Dependent Protein Deacetylase, Sirtuin, as a Biomarker of Healthy Life Expectancy: A Mini- Review. Current aging science. 2025;18(2):95-101. PMID: 39377386.
- 17Zhang X, et al. The effects of nicotinamide adenine dinucleotide in cardiovascular diseases: Molecular mechanisms, roles and therapeutic potential. Genes & diseases. 2021;9(4):959-972. PMID: 35685463.
- 18Poyan Mehr A, et al. PPARγ-Coactivator-1α, Nicotinamide Adenine Dinucleotide and Renal Stress Resistance. Nephron. 2017;137(4):253-255. PMID: 28591759.
- 19Mericskay M. Nicotinamide adenine dinucleotide homeostasis and signalling in heart disease: Pathophysiological implications and therapeutic potential. Archives of cardiovascular diseases. 2016;109(3):207-15. PMID: 26707577.
- 20Lin H. Nicotinamide adenine dinucleotide: beyond a redox coenzyme. Organic & biomolecular chemistry. 2007;5(16):2541-54. PMID: 18019526.
- 21Colombo G, et al. Insight Into Nicotinamide Adenine Dinucleotide Homeostasis as a Targetable Metabolic Pathway in Colorectal Cancer. Frontiers in pharmacology. 2021;12:758320. PMID: 34880756.
- 22Penberthy WT. Nicotinamide adenine dinucleotide biology and disease. Current pharmaceutical design. 2009;15(1):1-2. PMID: 19149596.
- 23Song S, et al. Nicotinamide Adenine Dinucleotide Supplementation Improves Cuprizone-Induced Multiple Sclerosis-Related Behavioral Changes in C57BL/6J Mice. Brain and behavior. 2025;15(5):e70525. PMID: 40320991.
- 24Palmer RD, et al. Precursor comparisons for the upregulation of nicotinamide adenine dinucleotide. Novel approaches for better aging. Aging medicine (Milton (N.S.W)). 2021;4(3):214-220. PMID: 34553119.
- 25Pospieszna B, et al. Erythrocyte nicotinamide adenine dinucleotide concentration is enhanced by systematic sports participation. BMC sports science, medicine & rehabilitation. 2024;16(1):216. PMID: 39407226.
- 26Ferro V, et al. NAD(+) (nicotinamide adenine dinucleotide, oxidized form). Trends in endocrinology and metabolism: TEM. 2025;36(3):292-293. PMID: 39266435.
- 27Harijith A, et al. The Role of Nicotinamide Adenine Dinucleotide Phosphate Oxidases in Lung Architecture Remodeling. Antioxidants (Basel, Switzerland). 2017;6(4). PMID: 29257052.
- 28Pei Z, et al. Nicotinamide Adenine Dinucleotide in the Development and Treatment of Cardiac Remodeling and Aging. Mini reviews in medicinal chemistry. 2022;22(18):2310-2317. PMID: 35249481.
- 29Xia X, et al. Nicotinamide adenine dinucleotide rejuvenates septic bone marrow mesenchymal stem cells. World journal of stem cells. 2025;17(2):96893. PMID: 40061269.
- 30Lu W, et al. Extraction and Quantitation of Nicotinamide Adenine Dinucleotide Redox Cofactors. Antioxidants & redox signaling. 2018;28(3):167-179. PMID: 28497978.
- 31Wang H, et al. Roles of Nicotinamide Adenine Dinucleotide Phosphate (NADPH) Oxidase in Angiogenesis: Isoform-Specific Effects. Antioxidants (Basel, Switzerland). 2017;6(2). PMID: 28587189.
- 32Kahn B, et al. A Narrative Review of Nicotinamide Adenine Dinucleotide (NAD)+ Intermediates Nicotinamide Riboside and Nicotinamide Mononucleotide for Keratinocyte Carcinoma Risk Reduction. Journal of drugs in dermatology : JDD. 2022;21(10):1129-1132. PMID: 36219044.
- 33Parikh SM. Metabolic Stress Resistance in Acute Kidney Injury: Evidence for a PPAR-Gamma-Coactivator-1 Alpha-Nicotinamide Adenine Dinucleotide Pathway. Nephron. 2019;143(3):184-187. PMID: 31055583.
- 34Rodriguez Cetina Biefer H, et al. Aspects of Tryptophan and Nicotinamide Adenine Dinucleotide in Immunity: A New Twist in an Old Tale. International journal of tryptophan research : IJTR. 2017;10:1178646917713491. PMID: 28659716.
- 35Huang Y, et al. Evaluating Nicotinamide Adenine Dinucleotide for Its Effects on Halo Blight of Snap Bean. Plant disease. 2023;107(3):675-681. PMID: 35881875.
- 36Liu X, et al. Impaired Nicotinamide Adenine Dinucleotide Biosynthesis in the Kidney of Chronic Kidney Disease. Frontiers in physiology. 2021;12:723690. PMID: 34603081.
- 37Liao C, et al. Nicotinamide adenine dinucleotide attenuates acetaminophen-induced acute liver injury via activation of PARP1, Sirt1, and Nrf2 in mice. Canadian journal of physiology and pharmacology. 2022;100(8):796-805. PMID: 35983933.
- 38Chakrabarti G, et al. Expanding antitumor therapeutic windows by targeting cancer-specific nicotinamide adenine dinucleotide phosphate-biogenesis pathways. Clinical pharmacology : advances and applications. 2015;7:57-68. PMID: 25870517.
- 39Yamaguchi S, et al. Safety and efficacy of long-term nicotinamide mononucleotide supplementation on metabolism, sleep, and nicotinamide adenine dinucleotide biosynthesis in healthy, middle-aged Japanese men. Endocrine journal. 2024;71(2):153-169. PMID: 38191197.
- 40Liu XY, et al. Nicotinamide adenine dinucleotide promotes synaptic plasticity gene expression through regulation N-methyl-D-aspartate receptor/Ca(2+)/Erk1/2 pathway. The Chinese journal of physiology. 2021;64(6):266-273. PMID: 34975119.
- 41Song Y, et al. Genome Analysis of Nicotinamide Adenine Dinucleotide-Independent Mycoplasma synoviae Isolates From Korea. Pathogens (Basel, Switzerland). 2021;10(10). PMID: 34684178.
- 42Lees JG, et al. Nicotinamide adenine dinucleotide induces a bivalent metabolism and maintains pluripotency in human embryonic stem cells. Stem cells (Dayton, Ohio). 2020;38(5):624-638. PMID: 32003519.
- 43Ryu CH, et al. Nicotinamide adenine dinucleotide phosphate oxidase inhibitor induces apoptosis on Epstein-Barr virus positive B lymphoma cells. Anatomy & cell biology. 2020;53(4):471-480. PMID: 33361545.
- 44Kirkland JB, et al. Niacin. Advances in food and nutrition research. 2018;83:83-149. PMID: 29477227.
- 45Kuerec AH, et al. Association between blood nicotinamide adenine dinucleotide levels and blood laboratory parameters at baseline and after nicotinamide mononucleotide supplementation in middle-aged healthy individuals: post hoc analysis of a randomized, double-blinded, placebo-controlled clinical trial. GeroScience. 2025. PMID: 41162813.
- 46Anithaa AC, et al. Nicotinamide adenine dinucleotide immobilized tungsten trioxide nanoparticles for simultaneous sensing of norepinephrine, melatonin and nicotine. Biosensors & bioelectronics. 2019;143:111598. PMID: 31442753.
- 47Liu J, et al. A Targeting Senescence and Recycling Intracellular Nicotinamide Adenine Dinucleotide Strategy for Attenuation of Senescence-Associated Phenotypes. ACS nano. 2025;19(36):32131-32144. PMID: 40911860.
- 48Merk V, et al. pH-Dependent Flavin Adenine Dinucleotide and Nicotinamide Adenine Dinucleotide Ultraviolet Resonance Raman (UVRR) Spectra at Intracellular Concentration. Applied spectroscopy. 2021;75(8):994-1002. PMID: 34076541.
- 49Arias-Mendoza F, et al. Assessment of Nicotinamide Adenine Dinucleotide in Human Tissues by In Vivo Phosphorus-31 Magnetic Resonance Spectroscopic Imaging at 1.5 Tesla. Advances in experimental medicine and biology. 2022;1395:323-328. PMID: 36527656.
- 50Tsurho V, et al. A zebrafish model of nicotinamide adenine dinucleotide (NAD(+)) deficiency-derived congenital disorders. bioRxiv : the preprint server for biology. 2025. PMID: 39829932.
- 51Prasanna J, et al. Role of nicotinamide adenine dinucleotide in cardiovascular disease. Current opinion in cardiology. 2026. PMID: 42047243.
- 52Cheng L, et al. A novel nicotinamide adenine dinucleotide control strategy for increasing the cell density of Haemophilus parasuis. Biotechnology progress. 2019;35(3):e2794. PMID: 30816004.
- 53Otsuka-Yamasaki Y, et al. Characterization of a novel nicotinamide adenine dinucleotide-cytochrome b5 reductase mutation associated with canine hereditary methemoglobinemia. The Journal of veterinary medical science. 2021;83(2):315-321. PMID: 33342963.
- 54Ministrini S, et al. A Liposomal Formulation Enhances the Anti-Senescence Properties of Nicotinamide Adenine-Dinucleotide (NAD(+)) in Endothelial Cells and Keratinocytes. Current issues in molecular biology. 2025;47(9). PMID: 41020844.
- 55WINER AD. CRYSTALLIZATION OF NICOTINAMIDE ADENINE DINUCLEOTIDE. The Journal of biological chemistry. 1964;239:PC3598+. PMID: 14245423.
- 56Matsuyama R, et al. Stabilization and quantitative measurement of nicotinamide adenine dinucleotide in human whole blood using dried blood spot sampling. Analytical and bioanalytical chemistry. 2023;415(5):775-785. PMID: 36504284.
- 57Liu L, et al. Exogenous nicotinamide adenine dinucleotide administration alleviates ischemia/reperfusion-induced oxidative injury in isolated rat hearts via Sirt5-SDH-succinate pathway. European journal of pharmacology. 2019;858:172520. PMID: 31278893.
- 58Liu Y, et al. [Glucose Metabolism-Derived Nicotinamide Adenine Dinucleotide Phosphate in Late-Onset Preeclampsia Placenta Tissue and Its Correlation with Oxidative Stress]. Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition. 2022;53(6):1028-1032. PMID: 36443047.
- 59Chaffin WL, et al. Nicotinamide adenine dinucleotide metabolism in Candida albicans. Journal of bacteriology. 1979;139(3):883-8. PMID: 225302.
- 60Eller J, et al. Improved Yield for the Enzymatic Synthesis of Radiolabeled Nicotinamide Adenine Dinucleotide. ACS bio & med chem Au. 2023;3(1):46-50. PMID: 36820310.
Everything you need to start.
Dose, sourcing, safety, our verdict. One purchase. Yours forever.
Built from 60 cited studies.