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Longevity & mitochondrial

NAD+

Also called nicotinamide adenine dinucleotide, β-NAD, NAD

NAD+ is not a peptide but a small helper molecule that every cell uses to make energy and repair DNA. Levels fall with age, so NAD+ injections and IV drips have become popular at wellness clinics. It is included here because it is often sold alongside peptides; the FDA has warned about contaminated NAD+ used in injections.

Early human dataSome small human studies exist; evidence is limited.

All printable flashcards

Illustration only. NAD+ is not a peptide.

Overview

NAD+ is not a peptide but a small helper molecule that every cell uses to make energy and repair DNA. Levels fall with age, so NAD+ injections and IV drips have become popular at wellness clinics. It is included here because it is often sold alongside peptides; the FDA has warned about contaminated NAD+ used in injections.

How it works

Established biology: NAD+ is a coenzyme in energy metabolism and a required substrate for sirtuin and PARP enzymes involved in DNA repair and cell signaling. Proposed: that giving NAD+ by injection or IV meaningfully raises cell NAD+ levels and slows aging. This has not been established in humans.

What research shows

  • No large controlled trials showing that injected or IV NAD+ improves health outcomes were verified in this review.
  • FDA (Oct 2024) received adverse-event reports after NAD+ injections — severe chills, shaking, vomiting and fatigue — consistent with endotoxin contamination from food-grade ingredients 3.

Doses studied in people

No dose from a published human trial or FDA label was verified; IV/injection protocols used at clinics are not trial-derived.

Read this first: these are the amounts given to participants in published studies or written on official prescribing labels, reported for reference. They are not recommendations. Trial doses were chosen for specific patients under medical supervision, and a dose that is safe in one person can be harmful in another.

Safety

  • FDA alert (Oct 30, 2024): food-grade NAD+ used to make IV products carried contamination risk; reported reactions included severe chills, shaking, vomiting and fatigue, some needing medical care 3.
  • Long-term safety of repeated high-dose NAD+ infusions is unknown.

Report side effects of any drug or product to the FDA through MedWatch. For a possible poisoning in the US, call Poison Control at 1-800-222-1222.

History

NAD was discovered in the early 1900s. Interest in 'NAD+ boosting' for aging grew in the 2010s. In 2019 FDA proposed not to include NAD in the 503A bulks list; it nonetheless remains listed in Category 1 (under evaluation) in FDA's May 2026 nominations list. In October 2024 FDA warned compounders after adverse events linked to food-grade NAD+ used for IV products.

Common questions

Is NAD+ FDA-approved?

No. NAD+ is not an FDA-approved drug, but it sits in Category 1 (under evaluation) on FDA's compounding list, where compounding is allowed for now under interim enforcement discretion 1. FDA had proposed in 2019 not to include it, and no final decision was found 2.

Do NAD+ injections or IV drips work?

This is unproven. No large controlled trials showing that injected or IV NAD+ improves health were verified, and it has not been shown to slow aging in people.

What doses were studied?

No dose from a published human trial or FDA label was verified. IV and injection protocols used at clinics are not based on trials.

Is NAD+ safe to inject?

In October 2024, FDA reported severe chills, shaking, vomiting and fatigue after NAD+ injections, consistent with contamination from food-grade ingredients 3. FDA asked compounders to use only ingredients suitable for sterile compounding 3.

Is NAD+ banned in sport?

It is not named on WADA's 2026 Prohibited List 4.

Related compounds

Longevity & mitochondrialFDA-approvedFlashcard

SS-31 (elamipretide)

elamipretide · Forzinity

SS-31, now called elamipretide, is a small lab-made peptide that travels to the mitochondria, the cell's power plants.

Longevity & mitochondrialPreclinical onlyFlashcard

Humanin

HN · HNG (S14G analogue)

Humanin is a small peptide made from genetic code inside the mitochondria.

Longevity & mitochondrialPreclinical onlyFlashcard

Epitalon

epithalon · epithalone

Epitalon is a tiny four-amino-acid peptide made in the lab, modeled on an extract from the pineal gland.

Sources

  1. FDA: Bulk Drug Substances Nominated for Use in Compounding Under Section 503A (updated May 14, 2026) Regulatory
  2. The FDA Law Blog: FDA Giveth and Taketh Away as It Publishes Its Second Proposed Rule Concerning the Section 503A Bulk Substances List (Sept 2019) Regulatory
  3. FDA: FDA reminds compounders to use ingredients suitable for sterile compounding (Oct 30, 2024) Regulatory
  4. WADA 2026 Prohibited List (official English text, Dutch Treaty Series Trb. 2026, 25) Regulatory

Wondering how to judge the claims made about compounds like this one? The Academy track Thinking clearly about peptide claims walks through it. You can try the Academy free first.

Last reviewed 2026-10-25 · How we research · Found an error? See our corrections policy.