NAD Injections Guide

Nicotinamide adenine dinucleotide (NAD) is one of the most abundant and important molecules in the body. In its oxidized form, NAD+, it helps convert food into cellular energy in the mitochondria. It is also used by enzymes that repair DNA and by sirtuins, a family of enzymes involved in metabolism, inflammation, and cellular stress responses.

Learn how NAD+ fits into care at SSK Longevity on our NAD+ page.

Research shows NAD+ levels steadily fall with age. Part of the decline is thought to come from increased use by enzymes such as CD38 and PARPs, which consume NAD+ during inflammation and DNA repair, along with reduced recycling. Lower NAD+ has been linked in animal research to reduced mitochondrial function and metabolic changes associated with aging.

In animal studies, restoring NAD+ levels has improved several markers of health and, in some models, lifespan. Whether the same benefits occur in people is an active area of research.

• Injections (subcutaneous or intramuscular) deliver smaller amounts in a quick, in-office or at-home format.
• IV infusions deliver larger amounts over a longer session and must be given slowly to limit side effects such as flushing and nausea.
• Oral precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are converted to NAD+ in the body. Human studies show they can raise blood NAD+ levels.

Which approach is appropriate depends on your goals, history, and tolerance, and is decided with your physician.

The strongest evidence for NAD+ comes from animal studies, where raising NAD+ improved metabolic health, mitochondrial function, and resilience to several age-related conditions. In humans, studies of oral precursors show they are generally well tolerated and raise NAD+ levels, but clear improvements in energy, cognition, or longevity have not yet been established in large trials.

Research on injected and IV NAD+ in humans is more limited. Reported benefits such as improved energy and mental clarity are largely based on clinical experience rather than controlled trials.

NAD+ is generally well tolerated. With injections, the most common effect is temporary discomfort or redness at the injection site. With IV infusions, flushing, nausea, headache, abdominal discomfort, and chest tightness can occur, usually when the infusion runs too quickly, and typically resolve when it is slowed.

Because NAD+ is compounded rather than FDA-approved, product quality depends on the pharmacy that prepares it. Long-term safety data in humans is limited. Patients who are pregnant or have certain medical conditions are evaluated individually.

No. There is no FDA-approved NAD+ drug product for any use. As of FDA's May 2026 update, NAD is listed in Category 1 of FDA's 503A bulk substances list, meaning it is under evaluation and FDA does not currently intend to take action against licensed pharmacies that compound it for individual patients under the conditions in its guidance. Category 1 is not an approval, and status can change as FDA's review continues.